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A Pleural Effusion Model in Rats by Intratracheal Instillation of Polyacrylate/Nanosilica
Published on: April 12, 2019
An unusual case of pericardial effusion
Aimann Surak1, Grace Bravo1, Amanda McMurray1
1Department of Paediatrics, Children's Hospital, London Health Sciences Centre, Western University, London, Ontario, Canada.
Insights
Kwashiorkor, a severe form of malnutrition, can cause pericardial effusion in children, even in developed countries. Prompt nutritional support is crucial for recovery when standard treatments fail.
Area of Science:
- Pediatrics
- Cardiology
- Nutritional Science
Background:
- Trisomy 21 (Down syndrome) is associated with various health complications.
- Pericardial effusion can be a serious condition requiring prompt diagnosis and treatment.
- Kwashiorkor, a severe protein-energy malnutrition, is typically seen in resource-limited settings.
Observation:
- A 13-year-old male with trisomy 21 presented with bilateral pneumonia, peripheral edema, and pericardial effusion.
- The pericardial effusion was refractory to standard medical interventions.
- Clinical evaluation revealed severe dietary restriction indicative of kwashiorkor.
Findings:
- The patient experienced severe hypoalbuminemia, hypocalcemia, hypomagnesemia, and hypophosphatemia.
- Gradual resolution of pericardial effusion and other symptoms occurred with the slow reintroduction of a balanced diet, adequate calories, and protein.
- Kwashiorkor was identified as the underlying cause of the pericardial effusion.
Implications:
- This case highlights kwashiorkor as an unusual but critical differential diagnosis for pericardial effusion, especially in developed nations.
- Malnutrition can be underdiagnosed in developed countries, leading to severe health consequences.
- Clinicians must consider nutritional assessment in patients with unexplained effusions or refractory symptoms, recognizing potential risk factors for malnutrition.
Abstract:
We report a case of a 13-year-old male with trisomy 21 in Southwestern Ontario, Canada, who presented with bilateral pneumonia, pericardial effusion, and peripheral oedema. The pericardial effusion did not respond to standard treatment options. Evaluation revealed severe dietary restriction, consistent with kwashiorkor. Hospital course was complicated by severe hypoalbuminaemia, hypocalcaemia, hypomagnesaemia, and hypophosphataemia. The pericardial effusion and other findings resolved gradually upon slow introduction of a well-balanced diet and adequate caloric and protein intake. Kwashiorkor is an unusual cause of pericardial effusion and can be overlooked especially in developed countries. It is a type of protein-calorie malnutrition often seen in children of impoverished countries and famine. It is a result of insufficient protein intake in the context of adequate caloric intake. Pericardial effusion not responding to usual treatment is a challenge, and other aetiologies must be considered. Malnutrition is often underdiagnosed or misdiagnosed in developed countries with devastating outcomes if unrecognised. This makes it imperative to consider this diagnosis, recognise potential risk factors, and be prepared to accurately assess overall nutritional status.
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