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Abstract Background Duchenne muscular dystrophy (DMD) is an X-linked muscular disease which is caused by the absence of dystrophin. Troponin elevation with acute chest pain may indicate acute myocardial injury in these patients. We report a case of DMD that presented with ACP and troponin elevation, who was diagnosed with acute myocardial injury, and successfully treated with corticosteroids. Case presentation A 9-year-old with DMD was admitted to the emergency department with the complaint of acute chest pain. His electrocardiogram (ECG) revealed inferior ST elevation and serum troponin T was elevated. The transthoracic echocardiography (TTE) demonstrated inferolateral and anterolateral hypokinesia with depressed left ventricular function. An ECG-gated coronary computed tomography angiography ruled out acute coronary syndrome. Cardiac magnetic resonance imaging revealed mid-wall to sub-epicardial late gadolinium enhancement at the basal to the mid inferior lateral wall of the left ventricle and corresponding hyperintensity on T2-weighted imaging, consistent with acute myocarditis. A diagnosis of acute myocardial injury associated with DMD was made. He was treated with anticongestive therapy and 2 mg/kg/day of oral methylprednisolone. Chest pain resolved the next day, and ST-segment elevation returned to normal on the third day. Troponin T decreased in the sixth hour of oral methylprednisolone treatment. TTE on the fifth day revealed improved left ventricular function. Conclusion Despite advances in contemporary cardiopulmonary therapies, cardiomyopathy remains the leading cause of death in patients with DMD. Acute chest pain attacks with elevated troponin in patients with DMD without coronary artery disease may indicate acute myocardial injury. Recognition and appropriate treatment of acute myocardial injury episodes in DMD patients may delay the development of cardiomyopathy.

Abstract Background Although acute coronary syndrome is rare in children, it is the most important cause of mortality in children with end-stage renal disease. Case presentation Here, a 16-year-old pediatric patient, who has been on dialysis since the age of 3, and who was diagnosed with acute coronary syndrome and placed an emergency percutaneous transcatheter stent in the left anterior descending branch of the left coronary artery is presented. It is important that the present patient does not have any electrocardiography findings in favor of cardiovascular disease and that he cannot fully explain the complaint of chest pain due to his mental retardation. Conclusions Early detection of acute coronary syndrome is life-saving, especially in children with chronic kidney disease.

Objective: The aim of this study is to determine the clinical signs of traumatic brain injury and its long-term effects on prognosis by evaluating the clinical and radiological findings of the patients admitted to the pediatric emergency department due to blunt head trauma. Method: The cases who applied to the pediatric emergency department due to head trauma were examined prospectively. Glaskow Coma (GCS) and Pediatric Trauma Scores (PTS) were calculated. The patients were evaluated neurologically 6 months after they were discharged. Results: A total of 707 pediatric patients [mean age: 59.8 +- 42.6 months; range: 1 month to 13 years; 263 (37.2%) girls] were evaluated prospectively. Pathology was detected in 101 cases (45.9%) [(epidural hematoma, 14; subdural hematoma, 11; brain edema, 36; intracerebral hematoma, 6; subarachnoid hemorrhage, 8; cerebral contusion, 22. Seventy-two (10.1%) patients had skull fractures.] Seventeen cases (2.4%) were operated, and 7 (1.4%) cases were lost. In children aged < 2 years vomiting, tachypnea, focal neurological findings, multitrauma, GCS 2 years old and with traumatic brain injury (p 2 years and with neurological sequelae (p

Complex clinical presentation with diverse timing of particular symptoms may cause diagnostic difficulties, especially in children and adolescents. This paper presents diagnostic difficulties and pitfalls in 3 children with acquired primary hypothyroidism due to Hashimoto's thyroiditis (HT) presenting with unusual manifestations. We described 3 children with acquired primary hypothyroidism due to HT. One of our patients had musculoskeletal pain and was diagnosed and treated as having connective tissue disease. Another patient presented with chest pain, dyspnea, and swelling in the abdomen. She had a massive pericardial effusion (PE). Two patients had severe growth failure. A third patient with Down syndrome had a small PE. Her complaint was dyspnea during sleep. All patients improved with thyroxin therapy. Patients with hypothyroidism due to HT who have complicated clinical manifestations were misdiagnosed and mismanaged at childhood and adolescence. Growth failure is an important sign in children and adolescents. In the presence of complicated manifestations in children and adolescents, thyroid dysfunction must be considered in differential diagnosis.