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Hiperfosfatasemia transitória benigna da infância e infeção a campylobacter jejuni
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Advisor(s)
Abstract(s)
Introdução: A Hiperfosfatasemia Transitória Benigna da Infância (HTBI) caracteriza-se pelo aumento transitório da fosfatase alcalina (FA) sérica, na ausência de doença hepática ou óssea. Tem sido associada a várias entidades, nomeadamente, infeções.
Caso clínico: Criança de dois anos, saudável, com episódios intermitentes de febre, dor abdominal, vómitos e dejeções de fezes moles com dois meses de evolução, sem alterações relevantes ao exame físico. Apresentava elevação da FA (2474 U/L), com função hepática, cálcio e fósforo normais. O exame bacteriológico de fezes foi positivo para Campylobacter jejuni. Efetuou tratamento com azitromicina, com resolução dos sintomas. Seis meses depois verificou-se normalização da FA.
Conclusão: A idade de apresentação, a ausência de doença subjacente e a normalização posterior da FA permitem o diagnóstico de HTBI. Fica por esclarecer, de acordo com os conceitos mais recentes, se a infeção pode ser considerada fator causal ou foi apenas o motivo para a realização do estudo analítico.
Introduction: Benign Transient Hyperphosphatasemia (BTH) is characterised by transient elevation of serum alkaline phosphatase (ALP) in the absence of liver or bone disease. It has been associated to several entities, namely infections. Case report: We describe the case of a healthy two-year-old child with intermittent episodes of fever, abdominal pain, vomiting and soft stool since two months ago, with no relevant changes on physical examination. The exams revealed elevated ALP (2474 U/L), with normal liver function, calcium and phosphorus. The stool culture was positive for Campylobacter jejuni. Clinical condition was resolved after antibiotic therapy with azithromycin. Six months later serum ALP values were normal. Conclusion: The age of presentation, the absence of underlying disease and subsequent normalization of ALP allow the diagnosis of BTH. It isn´t possible, according to the available literature, to guarantee if the infection was the cause of BTH or if it was the reason to perform the analytical study.
Introduction: Benign Transient Hyperphosphatasemia (BTH) is characterised by transient elevation of serum alkaline phosphatase (ALP) in the absence of liver or bone disease. It has been associated to several entities, namely infections. Case report: We describe the case of a healthy two-year-old child with intermittent episodes of fever, abdominal pain, vomiting and soft stool since two months ago, with no relevant changes on physical examination. The exams revealed elevated ALP (2474 U/L), with normal liver function, calcium and phosphorus. The stool culture was positive for Campylobacter jejuni. Clinical condition was resolved after antibiotic therapy with azithromycin. Six months later serum ALP values were normal. Conclusion: The age of presentation, the absence of underlying disease and subsequent normalization of ALP allow the diagnosis of BTH. It isn´t possible, according to the available literature, to guarantee if the infection was the cause of BTH or if it was the reason to perform the analytical study.
Description
Keywords
Campylobacter jejuni fosfatase alcalina hiperfosfatasemia transitória infeção alkaline phosphatase transient hyperphosphatasemia infection
Citation
Nascer e Crescer 2016; 25(1): 35-7