PROPUESTA PARA EL DIAGNÓSTICO PRECOZ DEL SÍNDROME DE NICOLAU EN NIÑOS DE 2 A 23 MESES
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Abstract
Introducción: El síndrome de Nicolau (SN), es una patología de etiología desconocida. Que inicia por una reacciona adversa posterior a la administración de medicación, por personal de salud, a pesar de ser este procedimiento parte de la práctica diaria. Objetivo: Establecer una propuesta para el diagnóstico precoz del SN en base a las manifestaciones clínicas. Métodos: Investigación de diseño documental, descriptivo y exploratorio, a través de revisión de artículos científicos, en bases de datos científicas como Scopus, Elsevier, Scielo, MEDLINE/Pubmed, Proquest, Medline, SciFinder, Springer y Biblioteca Virtual en salud Ecuador, utilizando las palabras clave: síndrome de Nicolau, diagnóstico precoz, terapia combinada. Desarrollo: El SN, presenta 3 fases, la inicial, caracterizada por edema leve, eritema y dolor continuo en los sitios de aplicación del medicamento. En los niños debilidad de miembros inferiores, una hora después del cumplimiento de la medicación, acompañado de incontinencia urinaria y fecal. La fase aguda, se presenta en 1 a 3 días con una placa livedoide endurecida en la zona afectada. La fase necrótica, aparece entre los 5 a 14 días, con ulceración en el área, formación de tejido de granulación y secreción purulenta, se puede desarrollar gangrena y mionecrosis muscular. El diagnóstico es clínico, complementado por biopsia, ecosonograma, ultrasonografía doppler y angiografía por tomografía. No existe protocolo terapéutico específico para la patología. Conclusiones: La elaboración de un diagrama para la identificación temprana del síndrome de Nicolau basado en la sintomatología, ayudara al personal de salud y padres de familia a un diagnóstico precoz, evitando complicaciones severas
Palabras clave: Síndrome de Nicolau, diagnóstico precoz, terapia combinada.
ABSTRACT
Introduction: Nicolau syndrome (SN) is a pathology of unknown etiology. That begins with an adverse reaction after the administration of medication by health personnel, despite the fact that this procedure is part of daily practice. Objective: To establish a proposal for the early diagnosis of NS based on clinical manifestations. Methods: Documentary, descriptive and exploratory design research, through the review of scientific articles, in scientific databases such as Scopus, Elsevier, Scielo, PubMed, Proquest, MEDLINE/Pubmed, SciFinder, Springer and Virtual Health Library Ecuador, using the words key: Nicolau syndrome, early diagnosis, combined therapy. Development: The NS, presents 3 phases, the initial, characterized by mild edema, erythema and continuous pain in the sites of application of the medication. In children, weakness of the lower limbs, one hour after compliance with the medication, accompanied by urinary and fecal incontinence. The acute phase occurs in 1 to 3 days with a hardened livedoid plaque in the affected area. The necrotic phase appears between 5 to 14 days, with ulceration in the area, formation of granulation tissue and purulent secretion, gangrene and muscle myonecrosis may develop. Diagnosis is clinical, supplemented by biopsy, echosonography, Doppler ultrasonography, and computed tomography angiography. There is no specific therapeutic protocol for the pathology. Conclusions: The elaboration of a diagram for the early identification of Nicolau syndrome
based on symptomatology, will help health personnel and parents to an early diagnosis, avoiding severe complications.
Keywords: Nicolau Syndrome, early diagnosis, combined therapy
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2. Lardelli PF, Jermini LMM, Milani GP, Peeters GGAM, Ramelli GP, Zgraggen L, Terrani I, Bianchetti M, Vanoni F, Faré, Plava C. Nicolau syndrome caused by non-steroidal anti-inflammatory drugs: Systematic literature review. Int J Clin Pract. 2020;74(10). URL: https://onlinelibrary.wiley.com/doi/10.1111/ijcp.13567
3. Saputo V, Bruni G. Nicolau syndrome from penicillin preparations: A review of the relevant literature in the search for potential risk factors. Pediatr Med Chir. 1998;20(2):105-123. URL: https://pubmed.ncbi.nlm.nih.gov/9706633/
4. Demircan C, Akdogan N, Elmas L. Nicolau Syndrome Secondary to Subcutaneous Glatiramer Acetate Injection. Int J Lower Extremity Wounds. 2020; 00(0): 1-3. DOI: https://doi.org/10.1177/1534734620973144
5. Kouamé YGS, Yaokreh JB, Sounkeré M, Tembely S, Ajoumissi IT, N'goran KE, Tomas AH, Hervé KT,Kouame DB, Ouattara O. Nicolau syndrome after intramuscular benzathine penicillin injection. J Pediatr Surg Case Rep. 2021;64:1-4 DOI: https://doi.org/10.1016/j.epsc.2020.101597
6. Gómez Alba V, Fernández J, Ferrán Pérez C, Santiago Rodríguez D, Mena F. Síndrome de Nicolau, manejo conservador: caso clínico. Cysa. 2019;3(2): 57-63 URL: https://revistas.intec.edu.do/index.php/cisa/article/view/1479/2064
7. Chagas CAA, Leite TFO, Pires LAS. Post-injection embolia cutis medicamentosa – Nicolau syndrome: Case report and literature review. J Vasc Bras. 2016;15(1):70-73. DOI: https://doi.org/10.1590/1677-5449.008315
8. Murdock JL, Duco MR, Sharma SC, Reeves DJ. Embolia Cutis Medicamentosa (Nicolau Syndrome) Secondary to Intramuscular Fulvestrant Injection: A Case Report. J Pharm Pract. 2021. DOI: https://doi.org/10.1177/08971900211012263
9. Marcus F, Claude EV, Josephine M, Teyang A. An Exceptional Cause of Acute Limb Ischemia: Nicolau Syndrome—Single-Center Experience with 4 Cases. Ann Vasc Surg. 2019; 58:383. e7-383.e11. DOI: https://doi.org/10.1016/j.avsg.2018.11.022
10. Kim KK, Chae DS. Síndrome de Nicolau: revisión de la literatura. Mundo J Dermatol. 2015; 4 (2): 103-107 Disponible en: URL: https://www.wjgnet.com/2218-6190/full/v4/i2/103.htm
11. Raju B, Ashraf O, Jumah F, Appaji Gowda NM, Gupta G, Sun H, Nanda A. Nicolau Syndrome, Masquerader of Postinjection Sciatic Nerve Injury: Case Report and Review of Literature. World Neurosurg. 2020;143:51-55. DOI: https://doi.org/10.1016/j.wneu.2020.07.029
12. Blind A, Lenormand C, Schissler C, Cribier B, Lipsker D. Suprapubic Nicolau syndrome following subcutaneous injection of glatiramer acetate. Ann Dermatol Venereol. 2018;145(11):671-675. DOI: 10.1016/j.annder.2018.04.012
13. Tabor D, Bertram CG, Williams AJK, Mathers ME, Biswas A. Nicolau Syndrome (Embolia Cutis Medicamentosa): A rare and poorly recognized iatrogenic cause of cutaneous thrombotic vasculopathy. Am J Dermatopathol.2018;40(3): 212-215.DOI: 10.1097/DAD.0000000000000972.
14. Dilts B, Sun K. Lucidchart. Compañía de creador del software; 2010. URL: https://lucid.app/es-LA/users/login#/login?clearStorage=true
15. Quincer E, Jaggi P. Nicolau Syndrome: A Rare Complication following Intramuscular Injection. J Pediatr. 2019; 212:238-238.E2. DOI: https://doi.org/10.1016/j.jpeds.2019.04.004
16. Stefano PC, Garello M, Nolte MF, Lamy P, Giglio N, Castellano V, Gentile Al. Nicolau syndrome induced by intramuscular injection of a hexavalent vaccine in a 6-month-old girl. Arch Argent Pediatr. 2017;115(1):e13-e16. URL: https://www.sap.org.ar/docs/publicaciones/archivosarg/2017/v115n1a16.pdf
17. Dorta LJ, Mantilla S, Haack K, Dorta M, Martes M. Nicolau syndrome. about a case. Rev Argent Dermatol. 2017;98(4): 1-10. URL: http://www.scielo.org.ar/scielo.php?script=sci_arttext&pid=S1851-300X2017000400006
18. Toro-Álvarez AM; Gaviria-Muñoz MA. Síndrome de Nicolau o embolia cutis medicamentosa: a propósito de un caso. Rev Asoc Colomb Dermatol. 2020;28(3):264-268. DOI: https://doi.org/10.29176/2590843X.1536
19. Bozkaya TA, Demirel G, Ormeci T, Al S, Çakar E, Tastekin A, Turkoglu H. Anticoagulant and vasodilator therapy for nicolau syndrome following intramuscular benzathine penicillin injection in a 4 year old boy. Arch Argent Pediatr. 2016;114(3):e184-e186. URL: https://www.sap.org.ar/docs/publicaciones/archivosarg/2016/v114n3a23e.pdf
20. Mott S, Peña Z, Spain R, White K. Nicolau syndrome and localized panniculitis: a report of dual diagnoses with an emphasis on morphea profunda-like changes following injection with glatiramer acetate. J Cutaneous Pathol. 2016;43(11):1056–1061. DOI: https://doi.org/10.1111/cup.12791
21. Aktas H, Y?lmaz OE, Ertugrul G, Terzi E. Intramuscular diclofenac is a cause of Nicolau syndrome in obese women: An observational study of consecutive ten patients. Dermatol Ther. 2020;33(3):1-3. DOI: https://doi.org/10.1111/dth.13392
22. Kartal SP, Alper M, Gürçay N. Nicolau syndrome: A rare complication of injection that should be kept in mind. Hong Kong J Dermatol Venereol. 2016;24(4):201-204. URL: http://medcomhk.com/hkdvb/pdf/2016v24n201-204.pdf
23. Zecca C, Mainetti C, Blum R, Gobbi C. Recurrent Nicolau syndrome associated with subcutaneous glatiramer acetate injection-a case report. BMC Neurol. 2015;15(1):1-4. URL: https://bmcneurol.biomedcentral.com/track/pdf/10.1186/s12883-015-0504-0.pdf
24. Enshaei A, Afshar A. Compartment syndrome of the calf due to Nicolau syndrome. Arch Bone Jt Surg. 2016;4(1):87-89. URL: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4733244/
25. Andre P, Haneke E. Nicolau syndrome due to hyaluronic acid injections. J Cosmet Laser Ther. 2016;18(4):239-244. DOI: https://doi.org/10.3109/14764172.2016.1157260
26. Maneshi A, Ravi S, Salehi MR, Hasannezhad M, Khalili H. Nicolau syndrome: Case report and review of reported cases in Iran. Arch Iran Med. 2017;20(1):60-64. URL: http://www.ams.ac.ir/AIM/NEWPUB/17/20/1/0013.pdf
27. Discua D, Mejia C, Acosta J, López C, Acosta R. Síndrome de Nicolau en paciente pediátrico posterior a la inyección intramuscular de penicilina benzatínica. Reporte de caso. MedPub. 2015;11(4):1-5. URL: file:///C:/Users/DELL/AppData/Local/Temp/Dialnet-SindromeDeNicolauEnPacientePediatricoPosteriorALaI-5391724-2.pdf
28. Tierce ML,IV, Schultz SM, Lanier BQ. Tissue loss with subcutaneous immunotherapy-Nicolau syndrome. J Allergy Clin Immunol Pract. 2016;4(1):154-155. DOI: https://doi.org/10.1016/j.jaip.2015.07.014
29. Arslan MN, Melez DO, Akcay A, Gur A, Sam B, Guven Apayd?n S. Coincidence of Nicolau Syndrome and Rhabdomyolysis: Report of a Forensic Autopsy Case and Review of the Literature. J Forensic Sci. 2016;61(5):1369-1374. DOI: https://doi.org/10.1111/1556-4029.13126
30. Kimbrough DJ, Newsome SD. Two cases of Nicolau syndrome associated with glatiramer acetate. Int J MS Care. 2017;19(3):148-150. DOI: https://doi.org/10.7224/1537-2073.2016-038
31. Elfatoiki FZ, Ennajdi A, Gueddari W, Chiheb S. Dermite livédoïde de Nicolau avec atteinte neurologique sévère chez un enfant [Nicolau livedoid dermatitis with severe neurological involvement in a child]. Ann Dermatol Venereol. 2017;144(6-7):426-429. French. doi: 10.1016/j.annder.2017.03.007. Epub 2017 Apr 12. PMID: 28412011.