До питання про рідкісні захворювання, які маніфестують у дітей лихоманкою і соматичним болем. Клінічний випадок

Abstract

Neuroblastoma is one of the most common tumor in the pediatric population, with the frequent localization in the retroperitoneal space. In the early stages disease can be asymptomatic and complicates diagnostic. The initial manifestations are not specific and can be considered as symptoms of different diseases. Purpose - to analyze and note some "red flags" of certain rare diseases that allow to suspect these diseases in children with fever and somatic pain. The article presents the data and clinical observation of a child with neuroblastoma with rapid progressive development and rapid metastasis. The features of the course and complications of the primary differential diagnosis of a malignant tumor process are described in a 3-year-old boy. The child was taken to the SI «Institute of Pediatrics, Obstetrics and Gynecology named of academician O.M. Lukyanova NAMS of Ukraine» with complaints of back pain, refusal to walk, weight loss and fever. The child was transferred to the intensive care unit for hemotransfusion due to progressive negative dynamics of the condition (pronounced pain syndrome, intoxication syndrome, oliguria). After demonstration an improvement the boy with the diagnosis of «Retroperitoneal neoplasm (neuroblastoma?), neoplasm of the left hand, neoplasm of the sternum; severe anemia of complex genesis; pathological compression fractures of vertebral bodies Th3, Th10, Th12 and L2; secondary hypoparathyroidism; functional bowel disorder; moderate degree of hypermetropia, strabismus, partial atrophy of the optic nerve» was transferred to the National Cancer Institute in the department of pediatric oncology for further examination and determination of the tactics of further therapy, where MRI of the brain and spinal cord with contrast, SCT of the head, chest, abdomen, pelvis, and bone biopsy were performed. This case will help pediatricians to suspect the presence of a tumor in the early stages and refer them to specialized specialists for the further examination as early as possible. The research was carried out in accordance with the principles of the Helsinki Declaration. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.