Images in Paediatrics
Respiratory distress syndrome due to pulmonary hypoplasia and neonatal congenital lymphedema
Síndrome de distrés respiratorio por hipoplasia pulmonar y linfedema congénito neonatal
Julio César Moreno Alfonso
, Alberto Pérez Martínez, Ada Y. Molina Caballero, Carlos Bardají Pascual
Corresponding author
Servicio de Cirugía Pediátrica, Hospital Universitario de Navarra, Pamplona, Spain
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Phenotype compatible with CLAPO syndrome.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Julio César Moreno Alfonso, Juan Carlos López Gutiérrez, Paloma Elena Triana Junco, María San Basilio Berenguer" "autores" => array:4 [ 0 => array:2 [ "nombre" => "Julio César" "apellidos" => "Moreno Alfonso" ] 1 => array:2 [ "nombre" => "Juan Carlos" "apellidos" => "López Gutiérrez" ] 2 => array:2 [ "nombre" => "Paloma Elena" "apellidos" => "Triana Junco" ] 3 => array:2 [ "nombre" => "María" "apellidos" => "San Basilio Berenguer" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S1695403322000236" "doi" => "10.1016/j.anpedi.2022.03.005" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1695403322000236?idApp=UINPBA00005H" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2341287923000558?idApp=UINPBA00005H" "url" => "/23412879/0000009800000004/v2_202304070152/S2341287923000558/v2_202304070152/en/main.assets" ] "en" => array:16 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Images in Paediatrics</span>" "titulo" => "Respiratory distress syndrome due to pulmonary hypoplasia and neonatal congenital lymphedema" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "323" "paginaFinal" => "324" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Julio César Moreno Alfonso, Alberto Pérez Martínez, Ada Y. Molina Caballero, Carlos Bardají Pascual" "autores" => array:4 [ 0 => array:4 [ "nombre" => "Julio César" "apellidos" => "Moreno Alfonso" "email" => array:1 [ 0 => "juliomoreno.md@gmail.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "Alberto" "apellidos" => "Pérez Martínez" "email" => array:1 [ 0 => "alperezma@gmail.com" ] ] 2 => array:3 [ "nombre" => "Ada Y." "apellidos" => "Molina Caballero" "email" => array:1 [ 0 => "adyemoca@yahoo.com" ] ] 3 => array:3 [ "nombre" => "Carlos" "apellidos" => "Bardají Pascual" "email" => array:1 [ 0 => "carlos.bardaji.pascual@navarra.es" ] ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Servicio de Cirugía Pediátrica, Hospital Universitario de Navarra, Pamplona, Spain" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Síndrome de distrés respiratorio por hipoplasia pulmonar y linfedema congénito neonatal" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1009 "Ancho" => 1342 "Tamanyo" => 143732 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Hard, cold and symmetrical oedema in legs and dorsum of feet with thickening of the dermis and ungual dysplasia (arrow).</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">We present the case of a male newborn aged 20 h in whom prenatal examinations had been normal and with a history of congenital oedema that had not been evaluated in first-degree relatives. At birth, he had respiratory distress that required non-invasive ventilation and swelling of the lower extremities. The physical examination revealed hard, cold oedema in both legs with thickening of the skin and ungual dysplasia (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>), in addition to hypoventilation in the base of the right lung.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">A chest radiograph and computed tomography scan evinced right pulmonary hypoplasia (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>A), and a lymphoscintigraphy was requested due to suspicion of congenital lymphoedema, which confirmed the absence of lymphatic vessels in the lower extremities (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>B). The patient received a clinical diagnosis of type I congenital lymphoedema type I, or Milroy disease.</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">At present, at age 7 months, the patient is free of respiratory symptoms and in treatment with lower extremity compression and physical therapy, with a favourable response (<a class="elsevierStyleCrossRef" href="#fig0015">Fig. 3</a>). Genetic testing is underway.</p><elsevierMultimedia ident="fig0015"></elsevierMultimedia><p id="par0020" class="elsevierStylePara elsevierViewall">Milroy disease is a rare condition with an estimated incidence of 1 case per 6000 live births with a 1:2.3 male-to-female ratio. It is caused by a variant in the <span class="elsevierStyleItalic">VEGFR3</span> gene encoding the vascular endothelial growth factor receptor 3, resulting in aplasia or dysplasia of lymphatic vessels.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> It manifests as congenital progressive oedema in the lower extremities, in isolation or as part of a syndrome.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> Although it is infrequent and it is still unclear what it is associated with, the presence of congenital lymphoedema must prompt an investigation of the family history and a lymphatic and genetic evaluation.<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> Appropriate multidisciplinary treatment may prevent progression to functional limitations, complications and sequelae. In selected cases refractory to conservative treatment, surgical treatment with vascularized lymph node transfer is a possible alternative that has achieved good results in recent case series.<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a></p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Funding</span><p id="par0025" class="elsevierStylePara elsevierViewall">This research did not receive any external funding.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Conflicts of interest</span><p id="par0030" class="elsevierStylePara elsevierViewall">The authors have no conflicts of interest to declare.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Funding" ] 1 => array:2 [ "identificador" => "sec0010" "titulo" => "Conflicts of interest" ] 2 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2022-03-28" "fechaAceptado" => "2022-06-09" "multimedia" => array:3 [ 0 => array:8 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1009 "Ancho" => 1342 "Tamanyo" => 143732 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Hard, cold and symmetrical oedema in legs and dorsum of feet with thickening of the dermis and ungual dysplasia (arrow).</p>" ] ] 1 => array:8 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1570 "Ancho" => 2609 "Tamanyo" => 229966 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0010" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">(A) Computed tomography evincing bilateral partial pulmonary hypoplasia, more marked on the right side (arrow). (B) Lymphoscintigraphy with visualization of axillary lymph nodes but not of popliteal and inguinal nodes, compatible with congenital lymphatic aplasia.</p>" ] ] 2 => array:8 [ "identificador" => "fig0015" "etiqueta" => "Figure 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 2363 "Ancho" => 1287 "Tamanyo" => 155610 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0015" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Progressive reduction of lymphoedema after 6 months of compression and physical therapy.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:4 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Linfedema congénito secundario a enfermedad de Milroy" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "E. Urbaneja" 1 => "R. Garrote" 2 => "M.A. Pino" 3 => "H. González" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.anpedi.2015.12.007" "Revista" => array:8 [ "tituloSerie" => "An Pediatr (Barc)." "fecha" => "2017" "volumen" => "86" "numero" => "3" "paginaInicial" => "169" "paginaFinal" => "170" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26818397" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0953620521001503" "estado" => "S300" "issn" => "09536205" ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Clinical aspects of congenital primary lymphedema" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "A.C. De Godoy" 1 => "L.M. De Godoy" 2 => "J.M. De Godoy" 3 => "M. De Fatima" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3233/PRM-190642" "Revista" => array:7 [ "tituloSerie" => "J Pediatr Rehabil Med." "fecha" => "2021" "volumen" => "14" "numero" => "1" "paginaInicial" => "51" "paginaFinal" => "53" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/32986626" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Enfermedad de Milroy o linfedema primario congénito asociado a carcinoma espinocelular invasor" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "O. Cheirif" 1 => "L. Ramírez" 2 => "S. Toussaint" 3 => "L. Lammoglia" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.ad.2016.05.011" "Revista" => array:7 [ "tituloSerie" => "Actas Dermosifiliogr." "fecha" => "2016" "volumen" => "107" "numero" => "10" "paginaInicial" => "864" "paginaFinal" => "866" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27374380" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0020" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Surgical treatment of Milroy disease" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "A. Bolletta" 1 => "G. Di Taranto" 2 => "S.H. Chen" 3 => "R. Elia" 4 => "V. Amorosi" 5 => "J.C. Chan" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1002/jso.25583" "Revista" => array:7 [ "tituloSerie" => "J Surg Oncol." "fecha" => "2020" "volumen" => "121" "numero" => "1" "paginaInicial" => "175" "paginaFinal" => "181" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/31165487" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/23412879/0000009800000004/v2_202304070152/S2341287923000509/v2_202304070152/en/main.assets" "Apartado" => array:4 [ "identificador" => "77701" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Images in Paediatrics" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/23412879/0000009800000004/v2_202304070152/S2341287923000509/v2_202304070152/en/main.pdf?idApp=UINPBA00005H&text.app=https://analesdepediatria.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2341287923000509?idApp=UINPBA00005H" ]
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