An infant with diaphragmatic eventration and respiratory distress.
The authors report a rare case of partial diaphragmatic eventration in a 4-month-old infant with recurrent wheezing and low serum IgA values. Because of persistent respiratory symptoms after therapy with inhaled short-acting beta2 agonists and inhaled nebulized corticosteroids, surgery was undertaken to correct the defect. Despite surgery, the clinical symptoms did not improve. Consequently, gatroesophagel reflux was considered and the diagnosis was confirmed with pH-metry, after which the infant was started on a protonic pump inhibitor therapy (PPI), achieving clinical improvement. Our experience suggests that in infants with congenital diaphragmatic eventration who present with respiratory distress gastro-oesophageal reflux should be suspected, and PPI therapy should be started before planning surgery.
Department of Pediatrics, Sapienza University of Rome, Roma, Italy. annamaria.zicari@uniroma1.it
A M
AM
Zicari
G
G
Tancredi
A
A
Rugiano
D
D
Zappalà
F
F
Midulla
L
L
Indinnimeo
G
G
De Castro
C
C
Celani
M
M
Duse
D003965:Diaphragmatic Eventration / Q000150:complications* / Q000628:therapy; D004417:Dyspnea / Q000209:etiology; D005764:Gastroesophageal Reflux / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D006801:Humans; D007070:Immunoglobulin A / Q000097:blood; D007223:Infant; D057045:Laryngopharyngeal Reflux / Q000188:drug therapy / Q000209:etiology; D008297:Male; D054328:Proton Pump Inhibitors / Q000627:therapeutic use; D012135:Respiratory Sounds / Q000209:etiology
D007070:Immunoglobulin A; D054328:Proton Pump Inhibitors