md-medicaldata

Authors

 

Dejana Bajić ^1,2, Nikola Eić ^1,2, Dragica Bulajić ², Nemanja Todorović², Zlatko Božić<sup>3

1</sup>Institute for Child and Youth Health Care of Vojvodina, Hajduk Veljkova 10, Novi Sad, Serbia
²Faculty of Medicine, University of Novi Sad, Hajduk Veljkova 3, Novi Sad, Serbia
³Primary Healthcare Center Bač, Bačka 2, Bač, Serbia

 

UDK: 616-056.7-053.2

The paper was received / Rad primljen: 23.02.2020.

Accepted / Rad prihvaćen: 02.03.2020.

 

Correspondence to:

Dr Dejana Bajić,
Institute for Child and Youth Health Care of Vojvodina
Hajduk Veljkova 10
21 000 Novi Sad, Serbia
+381 60 623 12 90
e-mail: dejnadeki@gmail.com

 

 

Sažetak

 

Uvod: Platipnea-ortodeoksija sindrom je redak klinički entitet koji se manifestuje arterijskom desaturacijom kada je pacijent u uspravnom položaju, a povlači se u horizontalnom. Prezentujemo Vam slučaj deteta uzrasta 3 meseca sa perifernom cijanozom u uspravnom položaju u čijoj osnovi je bio redak poremećaj-platipnea ortodeoksija sindrom. Prikaz slučaja: U kliničkoj slici pored mramorizovane kože, bila je uočljiva periferna cijanoza u uspravnom položaju i plavičaste sklere. Laboratorijske analize (izuzev povišenih laktata i D dimera), rendgensko snimak pluća i srca, ultrazvuk abdomena, CT grudnog koša i abdomena i elektroencefalogram su bili uredni. Ehokardiografskim nalazom detektovano je prisusutvo u interatrijalnom septumu secundum defekta i desno-levog šanta. Diskusija: Brojni su uzroci periferne cijanoze i svi moraju biti pažljivo razmotreni u okviru diferencijane dijagnoze. Najčešće je u osnovi  intrakardijalni šant, poremećaj odnosa ventilacija/perfuzija u plućnom parenhimu i plućni arterijsko-venski šant. Zaključak: Periferna cijanoza je deo kliničke slike različitih bolesti, ali njena manifestacija samo u uspravnom položaju diferencijalno dijagnostički može da uputi na redak entitet platiinea ortodeoksija sindrom.

 

 

Ključne reči:

ortodeoksija, periferna cijanoza, intrakardijalni šant, desno-levi šant

 

 

Abstract

 

Introduction: Platypnea-orthodeoxia syndrome is a rare clinical entity manifesting with arteriosus desaturation when a patient is in upright position, and retreats when a patient is lying. We are presenting a case of a 3-month old child with the symptoms of peripheral cyanosis in upright position caused by a rare platypnea -orthodeoxia syndrome. Case Report: In the clinical picture beside marmorized skin peripheral cyanosis was visible in upright position along with the bluish sclerae. Laboratory analyses (except for the increased lactates and D dimers), Chest X ray, Ultrasound of Abdomen, CT Thorax and Abdomen and electroencephalogram were normal. Echocardiographic finding showed the presence of a secundum defect in the interatrial septum and right-to -left shunt. Discussion:  The causes of peripheral cyanosis are numeral and all of them must be carefully inspected within a differential diagnosis. The most common causes are intracardiac shunt, pulmonary parenchymal ventilation /perfusion mismatch, and pulmonary arteriovenous shunts. Conclusion: Peripheral cyanosis is a part of a clinical picture of different diseases, but its manifestation only in upright position can indicate a rare entity of platypnea- orthodeoxia syndrome detected within a differential diagnosis.  

 

 

Key words:

orthodeoxia, peripheral cyanosis, intracardiac shunt, right to left shunt

 

 

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PDF Bajić D. et al • MD-Medical Data 2020;12(1): 033-036