Incidence of pediatric Horner syndrome and the risk of neuroblastoma: A population-based study

Stephen J. Smith, Nancy Diehl, Jacqueline A. Leavitt, Brian G. Mohney

Research output: Contribution to journalArticle

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Abstract

Objective: To describe the incidence of pediatric Horner syndrome and the risk of occult malignancy in a population-based cohort. Methods: The medical records of all pediatric patients (aged <19 years) residing in Olmsted County, Minnesota, who received diagnoses of Horner syndrome from January 1, 1969, through December 31, 2008, were retrospectively reviewed. Results: Horner syndrome was diagnosed in 20 pediatric patients during the 40-year period, yielding an age-and sex-adjusted incidence of 1.42 per 100 000 patients younger than 19 years of age (95% confidence interval [CI], 0.80-2.04). Eleven of the 20 patients (55%) had a congenital onset, for a birth prevalence of 1 in 6250 (95% CI, 3333-10 000), while the remaining 9 (45%) had acquired syndromes. Seven of the 11 (63.6%) patients with congenital cases had a history of birth trauma, while the remaining 4 (36.4%) had no identifiable cause. Six of the 9 (66%) acquired cases occurred following surgery or trauma, while the remaining 3 (33%) had no known etiology. None of the 20 patients (95% CI, 0.0%-16.8%) were found to have a neuroblastoma or other malignancy during a mean follow-up of 56.5 months (range, 0-256.9 months). Conclusions: The incidence of pediatric Horner syndrome in this population was 1.42 per 100000 patients younger than 19 years, with a birth prevalence of 1 in 6250 for those with a congenital onset. Birth, surgical, or other trauma occurred in 13 (65%) of the patients, while none were found to have an underlying mass lesion, suggesting a need for reappraising current recommendations for extensive evaluations in these patients.

Original languageEnglish (US)
Pages (from-to)324-329
Number of pages6
JournalArchives of Ophthalmology
Volume128
Issue number3
DOIs
StatePublished - Mar 2010

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Horner Syndrome
Neuroblastoma
Pediatrics
Incidence
Population
Parturition
Confidence Intervals
Wounds and Injuries
Reproductive History
Medical Records
Neoplasms

ASJC Scopus subject areas

  • Ophthalmology

Cite this

Incidence of pediatric Horner syndrome and the risk of neuroblastoma : A population-based study. / Smith, Stephen J.; Diehl, Nancy; Leavitt, Jacqueline A.; Mohney, Brian G.

In: Archives of Ophthalmology, Vol. 128, No. 3, 03.2010, p. 324-329.

Research output: Contribution to journalArticle

Smith, Stephen J. ; Diehl, Nancy ; Leavitt, Jacqueline A. ; Mohney, Brian G. / Incidence of pediatric Horner syndrome and the risk of neuroblastoma : A population-based study. In: Archives of Ophthalmology. 2010 ; Vol. 128, No. 3. pp. 324-329.
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abstract = "Objective: To describe the incidence of pediatric Horner syndrome and the risk of occult malignancy in a population-based cohort. Methods: The medical records of all pediatric patients (aged <19 years) residing in Olmsted County, Minnesota, who received diagnoses of Horner syndrome from January 1, 1969, through December 31, 2008, were retrospectively reviewed. Results: Horner syndrome was diagnosed in 20 pediatric patients during the 40-year period, yielding an age-and sex-adjusted incidence of 1.42 per 100 000 patients younger than 19 years of age (95{\%} confidence interval [CI], 0.80-2.04). Eleven of the 20 patients (55{\%}) had a congenital onset, for a birth prevalence of 1 in 6250 (95{\%} CI, 3333-10 000), while the remaining 9 (45{\%}) had acquired syndromes. Seven of the 11 (63.6{\%}) patients with congenital cases had a history of birth trauma, while the remaining 4 (36.4{\%}) had no identifiable cause. Six of the 9 (66{\%}) acquired cases occurred following surgery or trauma, while the remaining 3 (33{\%}) had no known etiology. None of the 20 patients (95{\%} CI, 0.0{\%}-16.8{\%}) were found to have a neuroblastoma or other malignancy during a mean follow-up of 56.5 months (range, 0-256.9 months). Conclusions: The incidence of pediatric Horner syndrome in this population was 1.42 per 100000 patients younger than 19 years, with a birth prevalence of 1 in 6250 for those with a congenital onset. Birth, surgical, or other trauma occurred in 13 (65{\%}) of the patients, while none were found to have an underlying mass lesion, suggesting a need for reappraising current recommendations for extensive evaluations in these patients.",
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N2 - Objective: To describe the incidence of pediatric Horner syndrome and the risk of occult malignancy in a population-based cohort. Methods: The medical records of all pediatric patients (aged <19 years) residing in Olmsted County, Minnesota, who received diagnoses of Horner syndrome from January 1, 1969, through December 31, 2008, were retrospectively reviewed. Results: Horner syndrome was diagnosed in 20 pediatric patients during the 40-year period, yielding an age-and sex-adjusted incidence of 1.42 per 100 000 patients younger than 19 years of age (95% confidence interval [CI], 0.80-2.04). Eleven of the 20 patients (55%) had a congenital onset, for a birth prevalence of 1 in 6250 (95% CI, 3333-10 000), while the remaining 9 (45%) had acquired syndromes. Seven of the 11 (63.6%) patients with congenital cases had a history of birth trauma, while the remaining 4 (36.4%) had no identifiable cause. Six of the 9 (66%) acquired cases occurred following surgery or trauma, while the remaining 3 (33%) had no known etiology. None of the 20 patients (95% CI, 0.0%-16.8%) were found to have a neuroblastoma or other malignancy during a mean follow-up of 56.5 months (range, 0-256.9 months). Conclusions: The incidence of pediatric Horner syndrome in this population was 1.42 per 100000 patients younger than 19 years, with a birth prevalence of 1 in 6250 for those with a congenital onset. Birth, surgical, or other trauma occurred in 13 (65%) of the patients, while none were found to have an underlying mass lesion, suggesting a need for reappraising current recommendations for extensive evaluations in these patients.

AB - Objective: To describe the incidence of pediatric Horner syndrome and the risk of occult malignancy in a population-based cohort. Methods: The medical records of all pediatric patients (aged <19 years) residing in Olmsted County, Minnesota, who received diagnoses of Horner syndrome from January 1, 1969, through December 31, 2008, were retrospectively reviewed. Results: Horner syndrome was diagnosed in 20 pediatric patients during the 40-year period, yielding an age-and sex-adjusted incidence of 1.42 per 100 000 patients younger than 19 years of age (95% confidence interval [CI], 0.80-2.04). Eleven of the 20 patients (55%) had a congenital onset, for a birth prevalence of 1 in 6250 (95% CI, 3333-10 000), while the remaining 9 (45%) had acquired syndromes. Seven of the 11 (63.6%) patients with congenital cases had a history of birth trauma, while the remaining 4 (36.4%) had no identifiable cause. Six of the 9 (66%) acquired cases occurred following surgery or trauma, while the remaining 3 (33%) had no known etiology. None of the 20 patients (95% CI, 0.0%-16.8%) were found to have a neuroblastoma or other malignancy during a mean follow-up of 56.5 months (range, 0-256.9 months). Conclusions: The incidence of pediatric Horner syndrome in this population was 1.42 per 100000 patients younger than 19 years, with a birth prevalence of 1 in 6250 for those with a congenital onset. Birth, surgical, or other trauma occurred in 13 (65%) of the patients, while none were found to have an underlying mass lesion, suggesting a need for reappraising current recommendations for extensive evaluations in these patients.

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