Fever for 2 months and disturbance of consciousness for 1 week in a preschool-aged girl

TIAN Mao-Qiang, LEI Wen-Ting, LANG Chang-Hui, LI Juan, TAN Jun-Mei, SHU Xiao-Mei

Chinese Journal of Contemporary Pediatrics ›› 2021, Vol. 23 ›› Issue (5) : 519-523.

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Chinese Journal of Contemporary Pediatrics ›› 2021, Vol. 23 ›› Issue (5) : 519-523. DOI: 10.7499/j.issn.1008-8830.2101101
CASE ANALYSIS

Fever for 2 months and disturbance of consciousness for 1 week in a preschool-aged girl

  • TIAN Mao-Qiang, LEI Wen-Ting, LANG Chang-Hui, LI Juan, TAN Jun-Mei, SHU Xiao-Mei
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Abstract

Rapid-onset obesity with hypothalamic dysfunction, hypoventilation, and autonomic dysregulation syndrome (ROHHADS) is a rare multi-system disease, and delayed diagnosis and treatment may lead to catastrophic cardiopulmonary complications. As far as we know, no patient with ROHHADS has been reported in China, and this article reports a child with ROHHADS to improve the awareness of this disease among clinicians. A girl, aged 3 years, had the clinical manifestations of rapid weight gain, fever, disturbance of consciousness, and convulsion. The physical examination showed a body weight of 20 kg, somnolence, irregular breathing, and stiff neck. She had increased blood levels of prolactin and follicle-stimulating hormone and hyponatremia. The lumbar puncture showed an increased intracranial pressure. The brain MRI and magnetic resonance venography showed symmetrical lesions in the periventricular region and venous thrombosis in the right transverse sinus and the superior sagittal sinus. The sleep monitoring showed hypopnea. The girl was finally diagnosed with ROHHADS and intracranial venous thrombosis. She recovered after symptomatic treatment including decreasing intracranial pressure, anticoagulation, and respiratory support. The possibility of ROHHADS should be considered for patients with unexplained obesity, fever, and hypoventilation, with or without central nervous system symptoms. Early diagnosis and standardized follow-up can improve the prognosis of children with ROHHADS.

Key words

Obesity / Autonomic dysfunction / Hypothalamus / Hypoventilation / Fever / Child

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TIAN Mao-Qiang, LEI Wen-Ting, LANG Chang-Hui, LI Juan, TAN Jun-Mei, SHU Xiao-Mei. Fever for 2 months and disturbance of consciousness for 1 week in a preschool-aged girl[J]. Chinese Journal of Contemporary Pediatrics. 2021, 23(5): 519-523 https://doi.org/10.7499/j.issn.1008-8830.2101101

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