Difference between revisions of "Pediatric pathology"
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{{Main|Neuropathology}} | {{Main|Neuropathology}} | ||
*Abbreviated ''HIE''. | *Abbreviated ''HIE''. | ||
===General=== | |||
*Autopsy adds some information. | *Autopsy adds some information. | ||
*Two-tone liver - suggests prior injury.<ref name=pmid15957995>{{cite journal |author=Elder DE, Zuccollo JM, Stanley TV |title=Neonatal death after hypoxic ischaemic encephalopathy: does a postmortem add to the final diagnoses? |journal=BJOG |volume=112 |issue=7 |pages=935–40 |year=2005 |month=July |pmid=15957995 |doi=10.1111/j.1471-0528.2005.00608.x |url=}}</ref> | *Two-tone liver - suggests prior injury.<ref name=pmid15957995>{{cite journal |author=Elder DE, Zuccollo JM, Stanley TV |title=Neonatal death after hypoxic ischaemic encephalopathy: does a postmortem add to the final diagnoses? |journal=BJOG |volume=112 |issue=7 |pages=935–40 |year=2005 |month=July |pmid=15957995 |doi=10.1111/j.1471-0528.2005.00608.x |url=}}</ref> | ||
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**Some hypoxic injuries that are prenatal do not occur after birth. | **Some hypoxic injuries that are prenatal do not occur after birth. | ||
***''Pontosubicular necrosis'' is prenatal; the subiculum postnatal (like in adults) is resistant to hypoxic-ischemic insults. | ***''Pontosubicular necrosis'' is prenatal; the subiculum postnatal (like in adults) is resistant to hypoxic-ischemic insults. | ||
**Hypoxic-ischemic insults are predominantly in the white matter. | **Hypoxic-ischemic insults are predominantly in the white matter. (???) | ||
*HIE is the most common cause of neonatal seizures and often difficult to control with anticonvulsants.<ref>URL: [http://emedicine.medscape.com/article/973501-overview http://emedicine.medscape.com/article/973501-overview]. Accessed on: 7 January 2011.</ref> | *HIE is the most common cause of neonatal seizures and often difficult to control with anticonvulsants.<ref>URL: [http://emedicine.medscape.com/article/973501-overview http://emedicine.medscape.com/article/973501-overview]. Accessed on: 7 January 2011.</ref> | ||
===Possible findings in HIE=== | |||
Hemorrhagic lesions:<ref name=pmid20626887 >{{cite journal |author=Riezzo I, Neri M, De Stefano F, ''et al.'' |title=The timing of perinatal hypoxia/ischemia events in term neonates: a retrospective autopsy study. HSPs, ORP-150 and COX2 are reliable markers to classify acute, perinatal events |journal=Diagn Pathol |volume=5 |issue= |pages=49 |year=2010 |pmid=20626887 |pmc=2914029 |doi=10.1186/1746-1596-5-49 |url=}}</ref> | |||
*Germinal matrix & intraventricular hemorrhage. | |||
*Choroid plexus hemorrhage. | |||
*Cerebellar hemorrhage. | |||
*Subpial hemorrhage. | |||
White matter lesions:<ref name=pmid20626887/> | |||
*Periventricular leukomalacia. | |||
*Subcortical leukomalacia. | |||
*Telencephalic (cerebral) leukomalacia. | |||
Grey matter lesions:<ref name=pmid20626887/> | |||
*Pontosubicular necrosis. | |||
*Infarcts of the cerebral cortex, basal ganglia, thalamus, brain stem. | |||
===Germinal matrix hemorrhage=== | ===Germinal matrix hemorrhage=== | ||
Revision as of 14:10, 7 January 2011
The article deals with paediatric pathology, which is quite different than adult pathology. Many diseases that afflict children are uncommon or unheard of in adults.
Persistent pulmonary hypertension of the newborn
- Abbreviated PPHN.
- Related to patent ductus arteriosus and persistent fetal circulation.[1]
Associations:[2]
- Meconium aspiration.
- Anemia.
- Infection.
- Pneumonia (severe).
- Hypoglycemia.
- Birth asphyxia.
Hypoxic-ischemic encephalopathy
Main article: Neuropathology
- Abbreviated HIE.
General
- Autopsy adds some information.
- Two-tone liver - suggests prior injury.[3]
- HIE in perinatal period may be unique to the specific time of the injury, i.e. the type of hypoxic insults vary by developmental stage.[4]
- Some hypoxic injuries that are prenatal do not occur after birth.
- Pontosubicular necrosis is prenatal; the subiculum postnatal (like in adults) is resistant to hypoxic-ischemic insults.
- Hypoxic-ischemic insults are predominantly in the white matter. (???)
- Some hypoxic injuries that are prenatal do not occur after birth.
- HIE is the most common cause of neonatal seizures and often difficult to control with anticonvulsants.[5]
Possible findings in HIE
Hemorrhagic lesions:[6]
- Germinal matrix & intraventricular hemorrhage.
- Choroid plexus hemorrhage.
- Cerebellar hemorrhage.
- Subpial hemorrhage.
White matter lesions:[6]
- Periventricular leukomalacia.
- Subcortical leukomalacia.
- Telencephalic (cerebral) leukomalacia.
Grey matter lesions:[6]
- Pontosubicular necrosis.
- Infarcts of the cerebral cortex, basal ganglia, thalamus, brain stem.
Germinal matrix hemorrhage
- Arises from the germinal matrix, the tissue from which neurons and glial arise from.[7]
- Location: periventricular; may cause an intraventricular hemorrhage.
- Image: Germinal matrix (nlm.nih.gov).[7]
- Location: periventricular; may cause an intraventricular hemorrhage.
- The germinal matrix is thought to be intrinsically fragile and is especially so in premature infants.
References
- ↑ URL: http://www.thechildrenshospital.org/wellness/info/parents/20830.aspx. Accessed on: 4 January 2011.
- ↑ URL: http://www.thechildrenshospital.org/wellness/info/parents/20830.aspx. Accessed on: 4 January 2011.
- ↑ Elder DE, Zuccollo JM, Stanley TV (July 2005). "Neonatal death after hypoxic ischaemic encephalopathy: does a postmortem add to the final diagnoses?". BJOG 112 (7): 935–40. doi:10.1111/j.1471-0528.2005.00608.x. PMID 15957995.
- ↑ Grafe MR, Kinney HC (February 2002). "Neuropathology associated with stillbirth". Semin. Perinatol. 26 (1): 83–8. PMID 11876572.
- ↑ URL: http://emedicine.medscape.com/article/973501-overview. Accessed on: 7 January 2011.
- ↑ 6.0 6.1 6.2 Riezzo I, Neri M, De Stefano F, et al. (2010). "The timing of perinatal hypoxia/ischemia events in term neonates: a retrospective autopsy study. HSPs, ORP-150 and COX2 are reliable markers to classify acute, perinatal events". Diagn Pathol 5: 49. doi:10.1186/1746-1596-5-49. PMC 2914029. PMID 20626887. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2914029/.
- ↑ 7.0 7.1 Ballabh P (January 2010). "Intraventricular hemorrhage in premature infants: mechanism of disease". Pediatr. Res. 67 (1): 1–8. doi:10.1203/PDR.0b013e3181c1b176. PMC 2799187. PMID 19816235. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2799187/.