Blog - INTERNET MÉDICA

Síndrome de Harlequin Online (Harlequin Syndrome)

Por Paulo Leite 23/11/2018

¨Síndrome de Harlequim ocorre em pacientes com distúrbio autonômico devido a uma denervação simpátic cutânea hemifacial, levando a anidrose unilateral e rubor facial reduzido ou ausente no lado afetado da face. Paradoxalmente, os pacientes apresentam rubor compensatório e suando no lado inrevado e simpático da face. Os braços e o tronco também podem ser afetados. Nos portadores desta síndrome, estresse térmico, exercício ou emoção súbita podem provocar uma alteração dramática na aparência facial, em que uma linha distinta divide a metade denervada, pálida e seca da metade intacta, vermelha e úmida. A paresia ocular simpática pode estar associada, mas nem sempre está presente. A maioria dos casos desta condição rara é de natureza primária. Em cerca de um sexto dos pacientes, no entanto, o distúrbio é causado por uma doença subjacente ou uma lesão estrutural (isto é, síndrome de Harlequin secundária). O tipo iatrogênico, que ocorre após procedimentos cirúrgicos, tem sido relatado com freqüência crescente. A síndrome é mais comum em mulheres e o constrangimento social é a principal queixa dos indivíduos afetados. A maioria dos pacientes não requer tratamento médico ou cirúrgico, a menos que haja uma doença subjacente. Nos pacientes com constrangimento significativo há necessidade de apoio psicológico, e a simpatectomia contralateral pode ser considerada.

■ Do you know this syndrome? Harlequin syndrome

Hans-Bittner, Nelise Ritter, Bittner, Guilherme Canho and Hans Filho, Günter

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http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0365-05962018000400019&lng=pt&nrm=iso

■ Harlequin syndrome following resection of mediastinal glanglioneuroma

Yeong Jeong Jeon, Jongbae Son, Jong Ho Cho

Korean J Thorac Cardiovasc Surg. 2017 Apr; 50(2): 130–132

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5380209/

■ Development of Harlequin syndrome following placement of thoracic epidural anesthesia in a pediatric patient undergoing Nuss procedure

Ashley Lefevre, Gregory Schnepper

Clin Case Rep. 2017 Sep; 5(9): 1523–152

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■ Idiopathic Harlequin syndrome manifesting during exercise: a case report and review of the literature

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■ Harlequin syndrome and Horner syndrome after neck schwannoma excision in a pediatric patient: a case report

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Medicine (Baltimore) 2017 Nov; 96(45): e854

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■ A pediatric case of idiopathic Harlequin syndrome

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■ Harlequin syndrome with contralateral anhidrosis after an upper chest gunshot woun

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■ Postexertional Harlequin syndrome with spontaneous improvement

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■ Harlequin syndrome in a case of toxic goitre: a rare association

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■ Harlequin syndrome after jogging

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■ Harlequin syndrome in two athletes

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by Dr Paulo Fernando Leite

■ Cardiologia/Prevenção Cardiovascular

■ Estratificação de Risco Cardiovascular

Av Contorno 8351 – Conj 01

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Email: pfleite1873@gmail.com

Pediatria: Diretrizes Médicas Online (Pediatrics: Medical Guidelines)

Por Paulo Leite 22/11/2018

■ Cardiopulmoary resuscitation in infants and children with cardiac disease

A Scientific Statement From the American Heart Association

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■ Guideline on pediatric day surgery of the Italian Societies of Pediatric Surgery (SICP) and Pediatric Anesthesiology (SARNePI)

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■ Wilson´s disease in children: A Position Paper by the Hepatology Committee of the European Society for Paediatric Gastroenterology, Hepatology and Nutrition

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■ Diagnosis and management of pediatric autoimmune liver disease: ESGHAN Hepatology Committee Position Statement

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■ The role of combination therapy in pediatric inflammatory bowel disease: A Clinical Report from the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition

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■ ECFS best practice guidelines: the 2018 revision

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■ Paediatric European Network for Treatment of AIDS (PENTA) guidelines for treatment of paediatric HIV-1 infection 2015: optimizing health in preparation for adult life

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(PENTA Steering Committee)

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■ Evaluating UK National Guidance for screening of children for tuberculosis: A prospective multicenter study

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■ Past, present and future approaches to the prevention and treatment of respiratory syncytial virus infection in children

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■ Mortality and morbidity in community-acquired sepsis in European pediatric intensive care units: a prospective cohort study from the European Childhood Life-thereatening Infectious Disease Study (EUCLIDS)

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■ Guidance on the use of probiotics in clinical practice in children with selected clinical conditions and in specific vulnerable groups

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■ Prevention of sports injuries in children at school: a systematic review of policies

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■ Consensus clinical management guideline for Niemann-Pick disease type C

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■ A systematic review and quality analysis of pediatric traumatic brain injury clinical practice guidelines

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■ KAAACI Evidence-based clinical practice guidelines for chronic cough in adults and children in Korea

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■ 2018 International Olympic Committee consensus statement on prevention, diagnosis and management of paediatric anterior cruciate ligament (ACL) injuries

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■ Guideline on management of the acute asthma attack in children by Italian Society of Pediatrics

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■ The management of children with bronchiolitis in the Australian hospital setting: development of a clinical practice guideline

Sharon O’Brien, Sally Wilson, Fenella J. Gill et al

on behalf of the Paediatric Research in Emergency Departments

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■ Clinical practice guidelines for diagnosis of autism spectrum disorder in adults and children in the UK: a narrative review

Jennie Hayes, Tamsin Ford, Hateem Rafeeque, Ginny Russell

BMC Psychiatry. 2018; vol 18: 222

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■ Towards high-quality, useful practice guidelines for child and youth mental health disorders: protocol for a systematic review and consensus exercise

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■ Dutch guidelines for clinical foetal-neonatal and paediatric post-mortem radiology, incluing a review of literature