Vascular Birthmarks - Pediatric Oncall

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Rakesh Kumar, Binay Ranjan, Manjul Vijay Department of Pediatrics, Katihar medical college, Katihar...

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	Specialist Answers
Question
Daughter is 11. Born with a vascular birthmark on 1/2 of her body (reminds you of a harlequin doll) birthmark is from neck down. At birth the medical team appeared concerned, since then we have moved to a new area of the country, medical staff here could care less. She is very active in sports. At least tries to be in basketball, softball, soccer, cheer leading, dance and gymnastics. initially after prolonged running, cheering, etc she would get left sided pain (waist area), the pain always starts there, followed by headache, vision problems, she can hear us when talking to her, but cannot answer us verbally, and it sounds like a chant she is saying (wondering if she is taking some sort of seizure). Episodes were less frequent, life flighted twice from sporting arena, and released. The pain is always the same, it starts in left side, reaches immediately down to the floor, she also has headache, starts chanting, SOB, she literally screams with the pain in side and her head. Once when life flighted she told us afterward she was not afraid because the angels were there. We asked her if she meant the nurses on the helicopter, she told us "no, the angels were there behind the nurses!" that is enough to give you the chills. The doctors here are letting it go as "growing pains" but the episodes are returning, now with all the symptoms her nose also has started to bleed. What do we do? Is she having seizures? Could this be an A-v malformation? No one here seems to care she has this vascular birthmark and I am concerned it is all related to one other. She is getting more frightened and so am I. we did have a cardiac consult, of which all proved negative. Now where do we go?
Answer
Rule out seizures, kasabach phenomenon with the vascular birth mark that may be leading to thrombocytopenia and bleeds and rule out porphyria. Back to All Questions

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