Eventos com aparente risco de vida: incidência, etiologia e investiga??o clínica

摘要

Objectives: Evaluate incidence, etiologic factors and the clinical investigation of patients with Apparent lifethreatening event – ALTE. Methods: Revision of Medline and LILACS articles from 1986-2006 and articles from “Associa??o Latinoamericana de Pediatria” (Pediatrics Latin American Association), selected from authors with recognized expertise with ALTE. Thirteen articles, from renowned authors, was reviewed together with three consensus: American about infantile apnea and home monitoring, Latin American consensus about ALTE and European Society consensus for the study and prevention of infant death. Results: The incidence of ALTE was described in studies as 0,6-2,27%. pproximately 50% of ALTE cases are symptomatic, being the most frequent etiologic pathologies the gastrointestinal and neurologic diseases. The ALTE episode can be the first presentation of many pathologies. The investigation must follow the standard protocol and must be focused to diagnose the base condition that will define prognostic. Recurrent cases without etiology established at initial investigation, need complementary exams, with child abuse and Munchausen by proxy being considered as differential diagnosis. Conclusion: The ALTE episode must be faced as the first manifestation of many diseases. It’s investigation must follow standard guidelines and be directed to define the base disease.