Stories about: Challenging Cases

Is it Kawasaki disease? Diagnosing challenging cases

Is it Kawasaki disease?A young child presents in your office with a fever of several days, erythema of the palms and soles of the feet, a rash on the trunk and a bright red tongue. For most pediatricians, this classic presentation of Kawasaki disease is fairly straightforward to diagnose.

“A majority of pediatricians have seen at least one case of Kawasaki in training,” says David Fulton, MD, chief emeritus of the Division of Cardiology Outpatient Services at Boston Children’s Hospital. “And most know how to make a diagnosis when all the clinical signs are present. But it’s important to understand the features of this disease that can make diagnosis more challenging.” …Read More

Challenging case: Diagnosing thyroid cancer

thyroid-cancer

The Thyroid Program at Boston Children’s Hospital is one of the first and largest centers in the United States exclusively devoted to the care and treatment of children with thyroid diseases. The expertise of a comprehensive, integrated team — including endocrinology, radiology, surgery, nuclear medicine, oncology and pathology, as well as oncologists from the Rare Tumors Program at Dana-Farber/Boston Children’s Cancer and Blood Disorders Center — attracts patients from across the country and around the world. …Read More

Challenging cases: Managing chronic lung disease after stem cell transplant

Helping our patients survive and thrive after stem cell transplant.It’s Donate Life Month, and at Boston Children’s Hospital’s Division of Pulmonary and Respiratory Diseases, we’re focused on helping our lung transplant recipients survive and thrive year-round.

We give these most critically ill children the best chance by working across disciplines to develop a long-term care plan, using new and innovative therapies when available. We are one of the few pediatric centers to offer photopheresis, a therapy that has been beneficial in treating graft vs. host disease (GVHD) and graft rejection in lung transplantation.

Craig Gerard, MD, PhD and team manage a challenging case.
Craig Gerard, MD, PhD

“As many stem cell transplant (SCT) patients later battle chronic lung disease, they are well served by our integrated team approach involving specialists in pulmonology, endocrinology and dermatology as well as experts in oncology from Dana Farber/Boston Children’s Cancer and Blood Disorders Center,” says Craig Gerard, MD, PhD, chief of the Division of Respiratory Diseases and the Leila and Irving Perlmutter Professor of Pediatrics.

Read the case of a patient treated with a bilateral lung transplant for pulmonary complications after SCT for refractory acute lymphoblastic leukemia who is now thriving.

…Read More

Challenging cases: Managing chronic kidney disease using genetic research

kidney disease

It’s World Kidney Day, and at the Boston Children’s Hospital Hildebrandt Lab, we’re focused on improving the lives of patients with chronic kidney disease (CKD) year-round. Our discoveries about the genetic causes of CKD have a direct impact on patient care. Worldwide, one in five cases of CKD in patients under age 25 is caused by one of 220 genes.

“To date, our research has identified over 80 of these genes. On average, we’re identifying one new gene every six weeks,” says Friedhelm Hildebrandt, MD, chief of nephrology at Boston Children’s Hospital and professor of pediatrics at Harvard Medical School. By pinpointing the exact cause of CKD, doctors can adjust the management of the disease and make appropriate recommendations to patients and their families that lead to better long-term outcomes. …Read More