https://jpnim.com/index.php/jpnim/issue/feed Journal of Pediatric and Neonatal Individualized Medicine (JPNIM) 2024-03-08T18:58:07+01:00 JPNIM Staff journal@jpnim.com Open Journal Systems <p>The <strong>Journal of Pediatric and Neonatal Individualized Medicine (JPNIM)</strong> is a peer-reviewed interdisciplinary journal which provides a forum on new perspectives in pediatric and neonatal medicine. The aim is to discuss and to bring readers up to date on the latest in research and clinical pediatrics and neonatology. Special emphasis is on developmental origin of health and disease or perinatal programming and on the so-called ‘-omic’ sciences. Systems medicine blazes a revolutionary trail from reductionist to holistic medicine, from descriptive medicine to predictive medicine, from an epidemiological perspective to a personalized approach. The journal will be relevance to clinicians and researchers concerned with personalized care for the newborn and child. Also medical humanities will be considered in a tailored way.</p> <p>Article submission (original research, review papers, invited editorials and clinical cases) will be considered in the following fields: fetal medicine, perinatology, neonatology, pediatrics, developmental programming, psychology and medical humanities.</p> https://jpnim.com/index.php/jpnim/article/view/e130104 The Journal of Pediatric and Neonatal Individualized Medicine (JPNIM) was awarded a “Journal of high cultural value” prize by the Italian Ministry of Culture: the reasons of success 2024-01-15T11:42:12+01:00 Vassilios Fanos vafanos@jpnim.com <p class="p1"><span class="s1">Dear Readers,<span class="Apple-converted-space"> </span></span></p> <p class="p1">I would like to share with you the news that, in November 2023, the <em>Journal of Pediatric and Neonatal Individualized Medicine</em> (JPNIM) was awarded a “Journal of high cultural value” prize by the Italian Ministry of Culture, through the General Directorate for Libraries and Copyright (with the decree D.D.G. n. 812, 16/11/2023). This is a great achievement as, in the biological-medical field, only a total of 3 journals were awarded by this decree.</p> <p class="p1"><span class="s1">This Editorial shows information a</span>bout JPNIM, JPNIM Open Access policy, JPNIM Editorial Board, JPNIM indexing and archiving, the fact that JPNIM is the official journal of many Societies, JPNIM publication, JPNIM website views and JPNIM metrics.</p> 2024-01-15T00:00:00+01:00 Copyright (c) 2024 © Hygeia Press https://jpnim.com/index.php/jpnim/article/view/e130103 Selected Lectures of the 3rd S.I.P.Ped. International Congress; Milan (Italy); November 29 - December 1, 2022 2024-01-15T18:29:12+01:00 --- Various Authors journal@jpnim.com <p class="p1"><strong>Selected Lectures of the 3<sup>rd</sup> S.I.P.Ped. International Congress • QUALITY OF LIFE AND ASSISTANCE OF MINOR WITH CHRONIC DISEASE: FROM PRE-BIRTH TO ADOLESCENCE <span class="s1">• </span><span class="s1">Milan (Italy) • November 29<sup>th</sup> - December 1<sup>st</sup>, 2022 </span></strong></p> <p class="p4"> </p> <p class="p1"><strong>LECT 1. THE EXPERIENCE OF PEDIATRIC PSYCHOLOGY IN MATERNAL AND CHILD DEPARTMENT • </strong>G. Perricone, C. Polizzi (Palermo, Italy) </p> <p class="p1"><strong>LECT 2. PEER RELATIONSHIPS AND ADOLESCENTS WITH CHRONIC DISEASE • </strong>A.M. La Greca (Coral Gables, FL, USA) </p> <p class="p1"><strong>LECT 3. PARENTAL ETHNOTHEORIES AND CHILD CARING IN MIGRANT FAMILIES • </strong>G.G. Valtolina (Milan, Italy) </p> <p class="p1"><strong>LECT 4. THE CENTRALITY OF THE CHRONIC CHILD IN ACCOMPANIMENT TO TREATMENT • </strong>G. Ragni, P. Becherucci, M. Lo Giudice, M. Picca (Latina, Florence, Palermo and Milan, Italy) </p> <p class="p1"><strong>LECT 5. THE PEDIATRIC PSYCHOLOGIST IN DERMATOLOGICAL CHRONICITY. MULTIDISCIPLINARY WORK EXPERIENCE IN THE CLINIC OF ATOPIC DERMATITIS • </strong>A. Dattolo (Rome, Italy) </p> <p class="p1"><strong>LECT 6. COULD THE NUTRITION OF THE PREGNANT WOMAN PREVENT DIFFERENT FORMS OF CHRONICITY? • </strong>F. Caturano (Turin, Italy) </p> <p class="p1"><strong>LECT 7. QUALITY OF LIFE AND CARE OF A CHILD WITH CHRONIC PATHOLOGY: FROM PRE-NATAL LIFE TO ADOLESCENCE • </strong>F. Monti (Bologna, Italy) </p> <p class="p1"><strong>LECT 8. TO CARE OF THE MINOR WITH NEURODEVELOPMENTAL DISORDERS IN THE TRANSITION TO THE ADULT PHASE • </strong>M.R. Morales (Varese, Italy) </p> <p class="p1"><strong>LECT 9. THE POWER OF EPIGENETICS IN PERINATALITY • </strong>V. Fanos (Cagliari, Italy) </p> 2024-01-15T00:00:00+01:00 Copyright (c) 2024 © Hygeia Press https://jpnim.com/index.php/jpnim/article/view/e130101 Pediatric oncological pain: the influence on the posture of the head and the spine. A narrative review 2023-08-11T19:04:36+02:00 Andrea Scribante andrea.scribante@unipv.it Matteo Pellegrini matteo.pellegrini@unimi.it Martina Ghizzoni martina.ghizzoni01@universitadipavia.it Maria Gloria Nardi mariagloria.nardi01@universitadipavia.it Barbara Rocca barbararocca81@gmail.com Marco Monticone marco.monticone@unica.it <p class="p1">Pediatric oncological pain (OP) is a common condition in children with cancer, resulting in postural changes in the head and spine, which significantly impact their quality of life. Osteosarcoma is the most prevalent type of pediatric tumor affecting head and spine districts. Its exact cause is still unknown, although it may be attributed to DNA mutations in bone cells, either inherited or acquired after birth; it often leads to bone and muscle pain and discomfort. This can initiate a harmful cycle, including mood disorders like anxiety and depression and maladaptive thoughts.<span class="Apple-converted-space"> </span></p> <p class="p1">Conducting a thorough functional assessment of children with OP is crucial, involving clinical and psychological evaluations and multidisciplinary rehabilitative approaches. A physical evaluation of the head and spine primarily focuses on assessing motor abilities through inspection of joint mobility, muscle strength, palpation, reflexes, and sensitivity.<span class="Apple-converted-space"> </span></p> <p class="p1">This narrative review considered randomized clinical trials, observational and cohort studies, and case reports; studies that did not meet inclusion criteria were excluded; 41 studies were selected for this review.<span class="Apple-converted-space"> </span></p> <p class="p1"><span class="Apple-converted-space"> </span>A team of healthcare professionals, including orthodontists, physiat­rists, pediatricians, oncologists, and psychologists, collaboratively manage children with OP, aiming to minimize the physical and mental disability caused by OP. It is based on education, exercise therapy, and psychological approaches.<span class="Apple-converted-space"> </span></p> <p class="p1">Education should include proper ergonomic postural guidance for sitting and standing, pain education (neuroscience education), and management of mood disorders and maladaptive thoughts (cognitive-behavioral education).</p> <p class="p1">Exercise therapy should focus on active postural correction, including exercises to counteract forward head posture, hyperkyphosis, and sway­back; strengthening exercises for spinal deep muscles; segmental stretching involving limbs and back muscles; and functional exercises.</p> <p class="p1">Psychological therapy, particularly cognitive-behavioral therapy, involves cognitive restructuring, time-based activity pacing, relaxation techniques, and adaptive coping strategies.<span class="Apple-converted-space"> </span></p> <p class="p1">This review pro­vides a comprehensive overview of the clinical postural assessment of the head and spine, which is essential for planning effective multidisciplinary rehabilitative treatments.</p> 2024-02-06T00:00:00+01:00 Copyright (c) 2024 © Hygeia Press https://jpnim.com/index.php/jpnim/article/view/e130105 Unlocking the secrets of metabolomics with Artificial Intelligence: a comprehensive literature review 2024-03-08T18:58:07+01:00 Karolina Krystyna Kopeć k.kopec@studenti.unica.it Federico Cannas fcannas1@gmail.com Cristina Piras cristina.piras@hotmail.it Martina Spada martina.spada@unica.it Antonio Noto antonio.noto@unica.it Luigi Atzori luigi.atzori@unica.it Vassilios Fanos vafanos@jpnim.com <p class="p1"><span class="s1">This comprehensive review synthesizes the wealth of scientific literature pertaining to the application of Artificial Intelligence (AI) in the field of metabolomics. Over the past decade, AI has played an increasingly pivotal role in deciphering the complexities of metabolomic </span>data, offering novel insights into the molecular underpinnings of biological <span class="s1">systems. Through an extensive examination of relevant research papers, we provide a comprehensive overview of the diverse AI techniques and methodologies, from data preprocessing and feature selection to predictive modeling and pathway analysis, employed in metabolomics studies. The review dissects key trends and advancements in AI-driven metabolomics, shedding light on its pivotal role in biomarker discovery, disease diagnosis, and personalized medicine. In addition to highlighting the significant contributions of AI to metabolomics, emerging frontiers will be explored, such as the incorporation of multi-omics data integration and the growing importance of explainable AI in biological research. Ultimately, this review underscores the transformative impact of AI on </span><span class="s2">metabolomics, emphasizing its potential to reshape </span><span class="s1">our understanding of metabolic pathways, disease mechanisms, and therapeutic interventions. The combination of AI and metabolomics stands as a powerful paradigm shift with far-reaching implications for advancing both fundamental scientific knowledge and practical applications across diverse domains.</span></p> 2024-03-11T00:00:00+01:00 Copyright (c) 2024 © Hygeia Press https://jpnim.com/index.php/jpnim/article/view/e130112 Effect of antenatal betamethasone on early systemic inflammatory indices in preterm infants with gestational age < 32 weeks 2023-07-21T10:26:13+02:00 Ufuk Cakir drufukcakir@hotmail.com Cuneyt Tayman ctayman22@gmail.com <p class="p1"><strong>Introduction:</strong> Antenatal glucocorticoid (AGC) therapy is routinely given to pregnant women when preterm delivery is expected. Systemic inflammatory indices are thought to have predictive value in some neonatal diseases. However, the effect of AGC on systemic inflammatory indices is unknown. The aim of this study was to evaluate the effect of AGC treatment on systemic inflammatory indices, morbidities and mortality in preterm infants.</p> <p class="p1"><strong>Methods:</strong> All preterm babies born at &lt; 32 weeks of gestation were evaluated retrospectively and included in the study. Systemic inflammatory indices, demographic characteristics and clinical results were compared by dividing the babies into groups based on the application of AGC to their mothers (24 mg betamethasone, 12 mg betamethasone and non-AGC).</p> <p class="p1"><strong>Results:</strong> A total of 869 preterm infants were evaluated in the study. As the use of AGC increased, respiratory distress syndrome and mortality were found to decrease significantly (p &lt; 0.001 and p = 0.018, respectively). No effect of AGC on other preterm morbidities and systemic inflammatory indices was detected (p &gt; 0.05).</p> <p class="p1"><strong>Conclusion:</strong> AGC had no effect on systemic inflammatory indices in preterm infants. The effect of AGC, especially on the lung, may be due to local effects rather than systemic effects.</p> 2024-02-24T00:00:00+01:00 Copyright (c) 2024 © Hygeia Press https://jpnim.com/index.php/jpnim/article/view/e130106 Frequency and risk factors of bronchopulmonary dysplasia in low-birth-weight infants in Saudi Arabia: a 5-year experience 2023-08-27T14:38:28+02:00 Ramadan A. Mahmoud ramadan.aboelhassan@yahoo.com Mahmoud Abdelrahman drmahmoud201085@gmail.com Ahmed Gharib a.gharib.dr@gmail.com Ahmed H. Elagami ahmed.hamdi.elagami@gmail.com Adli Abdelrahim a.abdelrahim@ksmc.med.sa Khalid Alfaleh mai.tharwat2017@gmail.com <p class="p1"><strong>Background:</strong> Due to improved survival of extremely low-birth-weight (ELBW) infants, the frequency of bronchopulmonary dysplasia (BPD) has remained unchanged or even increased.<span class="Apple-converted-space"> </span></p> <p class="p1"><strong>Objective:</strong> To study the frequency as well as the perinatal and neonatal risk factors of moderate-to-severe BPD and its related mortality in low-birth-weight (LBW) infants in a single-center study over 5 years in the Kingdom of Saudi Arabia (KSA).<span class="Apple-converted-space"> </span></p> <p class="p1"><strong>Methods:</strong> A total of 461 LBW infants’ files with gestational age (GA) ≤ 32 weeks that met the inclusion criteria were retrospectively reviewed. Maternal and neonatal characteristics were evaluated. Furthermore, the hospital course of management of LBW infants and outcomes of mortality and morbidity were recorded.<span class="Apple-converted-space"> </span></p> <p class="p1"><strong>Results:</strong> The overall mortality rate in LBW and ELBW infants was 19.52% and 38.62%, respectively. At 36 weeks’ corrected GA, the total BPD frequency in LBW and ELBW infants was 9.87% and 32%, respectively. BPD(+) cases had a lower mean GA and birth weight than BPD(-) cases, 26 ± 2.68 weeks, 830 ± 340 grams and 29 ± 2.56 weeks, 1,395 ± 470 grams, respectively (p &lt; 0.0001). The BPD(+) group had a significantly higher maternal chorioamnionitis infection rate, 8/39 (20.51%), than the BPD(-) group, 25/356 (7.02%) (p = 0.004), higher late-onset sepsis (11 [28.21%] and 54 [15.17%], p = 0.04). BPD(+) cases had a significantly higher risk of intubation in the delivery room, more frequently more than one dose of pulmonary surfactant, more invasive ventilation on day 1 and day 7, more days on oxygen therapy, more days on invasive and non-invasive ventilatory support, more days of hospitalization (115.41 ± 92.14 days compared to 43.72 ± 27.98 days in BPD[-]; all p &lt; 0.0001). </p> <p class="p1"><strong>Conclusion:</strong> ELBW infants had a 2-fold higher rate of mortality and a 3-fold higher rate of BPD, compared with LBW infants. The frequency of BPD increased with low GA/birth weight and BPD(+) cases had a higher risk for intubation in the delivery room, received more frequently more than one dose of pulmonary surfactant, remained for more days on either invasive or non-invasive ventilatory support, and had longer hospital stays.<span class="Apple-converted-space"> </span></p> 2024-01-23T00:00:00+01:00 Copyright (c) 2024 © Hygeia Press https://jpnim.com/index.php/jpnim/article/view/e130110 Selective immunoglobulin A deficiency and recurrent infections in children: how deep is this issue? 2023-07-18T10:56:15+02:00 Mirela Luminița Pavelescu mirela.pavelescu@umfcd.ro Irina Dijmărescu irinaandronie@yahoo.com Alexandru Dinulescu alexandru.dinulescu@rez.umfcd.ro Alexandru Sorin Păsărică alexandru-sorin.pasarica@rez.umfcd.ro Cristina Burtescu christina_cdgn@yahoo.com Cătălina Elena Lavric catalina-elena.lavric@rez.umfcd.ro Gheorghiță Jugulete gheorghita.jugulete@umfcd.ro Daniela Păcurar daniela.pacurar@umfcd.ro <p class="p1"><span class="s1"><strong>Background:</strong> Selective immunoglobulin A deficiency (SIgAD) is the most common primary immunodeficiency. Although most patients with SIgAD do not develop symptoms, some conditions related to SIgAD have been reported, particularly recurrent respiratory tract infections and infections caused by encapsulated microorganisms. Our objective was to evaluate the association of SIgAD with other pediatric conditions and extract data to establish an individualized protocol for managing patients with SIgAD.</span></p> <p class="p1"><span class="s1"><strong>Methods:</strong> We conducted a 3-year retrospective epidemiological study of 57 pediatric patients (aged 4-17 years) diagnosed with SIgAD after admission to the Pediatrics Department of “Grigore Alexandrescu” Emergency Children’s Hospital in Bucharest, Romania. The type of infection (location, etiologic agent, and severity) and associated allergic and immune disorders were analyzed.</span></p> <p class="p1"><span class="s1"><strong>Results:</strong> Respiratory tract infections were the main conditions observed in patients with SIgAD (86.0%), and recurrence was reported in over half of the patients (54.4%). Overall, 42.1% of patients had acute digestive involvement. Of the 93 infections (positive culture), in 37 cases (39.8%) encapsulated germs were involved. Among the encapsulated germs, <em>Klebsiella pneumoniae</em> was isolated in 11 cases (29.7%), <em>Staphylococcus aureus</em> in 9 cases (24.3%), <em>Escherichia coli,</em> <em>Streptococcus pneumoniae </em>and<em> Haemophilus influenzae </em>each in 5 cases (13.5%), and <em>Pseudomonas aeruginosa</em> was identified in 2 cases (5.4%). Several patients had recurrent or multiple infections – for 20 (35.1%) out of the 57 children, 2 microorganisms were identified at different points in time during the study period, and for 8 children (14.0%), 3 microorganisms were identified at the same time. Allergic-associated markers or allergic events were found in 20 children (35.1%) and celiac disease was diagnosed in 3 patients (5.3%).</span></p> <p class="p1"><strong>Conclusions:</strong> Although SIgAD is a primary immunodeficiency that is not immediately life-threatening, infections are potentially disabling. <span class="s2">Therefore, primary care physicians and pediatricians </span>should closely monitor patients with SIgAD.</p> 2024-02-07T00:00:00+01:00 Copyright (c) 2024 © Hygeia Press https://jpnim.com/index.php/jpnim/article/view/e130109 Value of maternal tactile method in detecting fever among under five years children during the COVID-19 era 2023-03-19T21:42:21+01:00 Ali Adel Shareef ali.adel@uoninevah.edu.iq Nuha Hachim Alasaf drnuha@uomosul.edu.iq Marab Younis Abdullah Al-Fathy dr.marabpublichealth@gmail.com <p class="p1"><strong>Objectives: </strong>The ability of mothers to accurately predict the presence of fever in their children using the tactile method is still controversial. This study evaluated the accuracy of Iraqi mothers’ tactile fever detection in children under 5 during COVID-19 pandemic.</p> <p class="p1"><strong>Materials and methods: </strong>Interviews were conducted with 200 mothers whose children were under the age of 5 years and who assumed they had fever. Each mother was then asked to touch her child’s body for fever evaluation, while an investigator observed them, recorded their responses, and documented the places of palpation. Thereafter, the investigator determined the child’s temperature using a non-contact temple thermometer (NCTT). Statistical analysis was conducted to compare the maternal tactile approach to NCTT and single site to multiple site palpation in terms of sensitivity, specificity, and predictive values.</p> <p class="p1"><strong>Results: </strong>The prevalence of fever in the study sample was 72%, as 144 of the 200 children involved were confirmed to have fever by NCTT. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the maternal tactile method were 96.5%, 62.5%, 86.9%, and 87.5%, respectively. Multiple child body sites were palpated by 42.5% of mothers, whereas 57.5% palpated a single site, with the forehead being the most common palpated site (31%). Multiple site palpation had a significantly lower incorrect temperature assessment rate than single site palpation (3.5% vs. 27%, p = 0.00001). Additionally, the accuracy increased significantly when the mother palpated multiple sites (96.5% vs. 73%).</p> <p class="p1"><strong>Conclusion:</strong> The findings of this study suggest that mothers’ use of tactile assessment is an effective screening tool when assessing their children’s fever; however, mothers’ fears can reduce the accuracy of this method, whereas instructing the mother to palpate multiple body parts can increase its reliability.<span class="Apple-converted-space"> </span></p> 2024-02-15T00:00:00+01:00 Copyright (c) 2024 © Hygeia Press https://jpnim.com/index.php/jpnim/article/view/e130108 Clinical profile and outcome of COVID-19-positive children in a tertiary care centre of North-East India 2022-05-29T12:07:16+02:00 Aditi Baruah aditibaruah2812@gmail.com Dilip M. Chowdhary dilipmchowdhary@gmail.com Pritikar Dowerah pritikardowerah@gmail.com Kumari Naina knaina5116@gmail.com <p class="p1"><strong>Introduction:</strong> COVID-19 infection is said to be generally a milder disease in children, compared to adults, and is associated with much lower case-fatality rates. Objective of this study was to find out the clinical characteristics and outcome of COVID-19-positive children and also the differences between the first and the second waves, if any.</p> <p class="p1"><strong>Methodology:</strong> This was a retrospective study done in the Department of Paediatrics of a tertiary care teaching hospital. Departmental and hospital medical records were reviewed to assess the clinical characteristics, disease severity and outcome of all COVID-19-positive admitted children from May 2020 to September 2021 (the first wave from May 2020 to January 2021 and the second wave from April 2021 to September 2021). Data analyses were done in Microsoft® Excel® 2010.<span class="Apple-converted-space"> </span></p> <p class="p1"><strong>Results:</strong> Out of total 560 COVID-19-positive children attending the hospital during the study period, 266 children (76 in the first wave and 190 in the second wave) were admitted. The majority of the children (25%) were in the age group of 1-6 months during the first wave, while in the second wave the majority of the children (27.9%) were in the age group of 5-10 years. The most common presenting complaint was fever (51.1%), followed by cough (13.9%). Co-morbidities were present in 23.3% of cases. Asymptomatic, mild, moderate, severe and critical cases were 16.5%, 51.9%, 18.4%, 6.4% and 6.8%, respectively. The case fatality ratio was 3.75% (21/560) among all positive cases. Ventilator support was required in only 10.1% of cases. There were some significant differences between the 2 waves regarding age distribution, disease severity, outcome and some presenting complaints.</p> <p class="p1"><span class="s1"><strong>Conclusions:</strong> The majority of the COVID-19 in­fections were either asymptomatic or of mild variety. Males suffered more than females. The admission rate was higher in the second wave but death was higher in the first wave, indicating higher infectiousness and milder nature of the disease in the second wave. Most of the deaths occurred within 24 hours of admission, indicating that late admission may be an important risk factor for mortality. Except for age distribu­tion, severity and outcome, other parameters were comparable between the first and the second wave.</span></p> 2024-02-22T00:00:00+01:00 Copyright (c) 2024 © Hygeia Press https://jpnim.com/index.php/jpnim/article/view/e130114 Compound heterozygous TRMU gene mutations in an infant with transient cholestasis and hyperlactatemia 2021-08-12T19:47:09+02:00 Barbara Parma barbaraparma79@hotmail.com Serena Motta s.motta@asst-monza.it Erika S. Apuril Velgara erika.apuril@gmail.com Angelo Selicorni angelo.selicorni61@gmail.com Lisa Licini llicini@asst-pg23.it Maurizio Cheli mcheli@asst-pg23.it Lorenzo D'Antiga ldantiga@asst-pg23.it Maria Iascone miascone@asst-pg23.it Emanuele Nicastro enicastro@asst-pg23.it Serena Gasperini s.gasperini@asst-monza.it <p class="p1"><span class="s1">The authors present an atypical case of an infant with unremarkable familiar, birth, and neonatal history who developed a mild/benign form of transient cholestasis. At admission, second- and third-level assessments were conducted, mitochondrial respiratory chain disorders were ex­cluded. The patient was accurately and promptly diagnosed through a clinically driven genetic test. The genetic analysis evidenced a compound heterozygous mutation c.383A&gt;G (p.Tyr128Cys) of maternal origin and c.835G&gt;A (p.Val279Met) of paternal origin in the <em>TRMU</em> gene associated </span><span class="s2">to transient infantile liver failure, a condition known for its progressive and sometimes fatal prognosis. Biochemical test and patient’s clinical evolution were both good and there was no evidence of liver failure or dysfunction of </span><span class="s1">other organs. This is the first-ever reported case of a patient with a <em>TRMU</em> pathological compound mutation with such good clinical evolution.</span></p> 2024-02-13T00:00:00+01:00 Copyright (c) 2024 © Hygeia Press https://jpnim.com/index.php/jpnim/article/view/e130102 Renal artery fibromuscular dysplasia: diagnostic challenges in a child presenting with hyponatremic hypertensive syndrome (HHS) 2022-12-17T19:12:21+01:00 Asrar Abu Bakar asrarabubakar@iium.edu.my Sharifah Aishah Syed Ahmad Alsagoff aishahalsagoff@iium.edu.my Muhamad Azamin Anuar azamin@iium.edu.my Ganeshwara Durai Raja Lingam ganeshwaralingam@gmail.com <p class="p1">A 2-year-9-month-old boy presented with renovascular hypertension caused by middle-segment stenosis of the right renal artery, and a severe hypertensive crisis, accompanied by hyponatremia, hypokalemia, and transient proteinuria. Fibromuscular dysplasia (FMD) is the most common cause of renovascular disease in children. However, the diagnosis of FMD is often delayed because findings on renal sonograms with Doppler are frequently missed. A high index of suspicion is required to further investigate a renovascular cause when persistent hypertension in a child cannot be otherwise explained. We present the challenges of reaching a diagnosis in a resource-limited setting and discuss how a multidisciplinary approach was key to successfully manage a young child with renovascular disease.</p> 2024-03-12T00:00:00+01:00 Copyright (c) 2024 © Hygeia Press