BackgroundNon-alcoholic fatty liver disease (NAFLD) is the most prevalent chronic hepatic disorder in the pediatric population and has grown along with the obesity pandemic in which we live today. Adipose tissue storage in the upper body segment has been positively correlated with visceral adiposity and metabolic disease, which suggests that neck circumference could represent an easily accessible and replicable anthropometric measurement to identify patients with a higher risk of developing NAFLD. The main purpose of this study is to determine if there is an association between neck circumference and NAFLD. The secondary objectives are to establish cutoff values based on gender and puberty staging.MethodsWe included a sample pediatric population of 112 patients diagnosed with obesity aged between 6 and 18 years. We performed anthropometric and metabolic measurements on every patient, and NAFLD diagnosis was determined with hepatic ultrasound.ResultsThe neck circumference was larger in NAFLD pediatric patients compared to those without NAFLD (p = 0.001). In a multivariate analysis, the neck circumference was associated with NAFLD as an independent risk factor (odds ratio [OR] = 1.172; 95% CI = 1.008–1.362; p = 0.038). Tanner 2–3 = 35 cm and Tanner 4–5 = 38 cm were established as risk cutoff values to develop NAFLD in the male adolescent population.ConclusionsThere is an association between the neck circumference and NAFLD in pediatric patients with obesity, particularly in the male population.

RESUMENLa morfea inducida por radioterapia es una rara complicación de etiología desconocida. El diagnóstico es de exclusión y el tratamiento no se encuentra estandarizado. Describiremos el caso de una mujer de 51 años con antecedente de artritis reumatoide y cáncer de mama, la cual tres meses después del término de radioterapia presentó dolor ardoroso localizado en la mama izquierda, acompañado de eritema, engrosamiento y edema de la piel. Clínicamente tenía la mama izquierda retraída, indurada, con eritema brillante, aumento de la temperatura y aspecto de piel de naranja. Recibió tratamiento antibiótico, analgésico y antiinflamatorio sin mejoría. Tomamos una biopsia de la lesión que reportó fibrosis en la dermis y tejido celular subcutáneo, atrofia de folículos pilosos y ausencia de anexos; hallazgos muy sugestivos de morfea inducida por radioterapia. Al descartarse recurrencia, iniciamos tratamiento tópico con esteroides y antiinflamatorios sistémicos, mejorando notablemente el cuadro.