Scafati. In a coma due to an autoimmune reaction to an ovarian teratoma, she undergoes surgery and awakens. It's the result of a complex procedure on an 18-year-old girl from Scafati at the Cardarelli Hospital in Naples. "My daughter was literally snatched from death. I can never thank enough the doctors who treated her and the nurses who cared for her." Her mother, Rosaria,'s words are charged with emotion and outline a new chapter in good healthcare, set against the backdrop of the pavilions of the Antonio Cardarelli Hospital in Naples.
The young life snatched from death is that of Ilaria, an eighteen-year-old from Scafati, who found herself catapulted into a nightmare overnight: first the loss of lucidity, then difficulty walking and finally a coma. Only after arriving at the Cardarelli was the definitive diagnosis made, very complex given the apparent lack of a cause. Shortly after, a courageous operation was carried out with the patient in a coma, but capable of returning her to her loved ones and plans for the future. The "angels" that mother Rosaria speaks of are those of the multidisciplinary team that dealt with the case and composed of the primary physicians Ciro Florio (Neurology department) and Claudio Santangelo (Gynecology department), the gynecologist Simona Sorrentino, the neurologist Giorgia Maniscalco and the anesthetist Maria Loreto. But more generally, the family's thoughts go out to all the staff at the Hospital Trust who for almost a month held their breath and cheered for Ilaria.
"Until we arrived at Cardarelli," says mother Rosaria, "there was no definitive diagnosis for my daughter. The doctors in Nocera had to first rule out other causes; they first thought of a personality disorder, then meningitis. My daughter, however, continued to get worse, and in the end it was necessary to transfer her to Naples."
Thus, on August 20, Ilaria was admitted to the Neurology department directed by Ciro Florio. From the tests already performed and from new investigations, the doctors began to believe that it could be an ovarian teratoma. "A benign tumor," explains Claudio Santangelo, the surgeon who then performed the operation, "with a complex structure characterized by the presence of multiple tissues in which a more or less evolved organoid differentiation can be detected. For example, outlines of bones, adrenal glands, teeth or nervous structures and so on." To put it simply, the consequence was that Ilaria's immune system began to fight the tumor, but also healthy cells of the brain tissue.
For Ilaria, a very complex diagnosis, supported by the presence of what in medical jargon are called "anti MNDA antibodies". "The tests carried out in the hospital of origin - says Ciro Florio - gave us an important clue for the definition of the case. The girl evidently had what is called limbic encephalitis. A condition in which the antibodies produced by the immune system attack the NMDA receptors found in the brain". Hence the decision to proceed with a therapy based on immunoglobulins, which however does not produce the hoped-for improvements. The choice to proceed with the operation was courageous but necessary, also in consideration of the delicate and now very compromised conditions of the young woman.
On August 28, the decision was made: surgery was necessary. The operation was long and complex, but ended favorably. The surgeon's skill allowed the procedure to be performed laparoscopically and in the following days, what seemed like a miracle to the family occurred: Ilaria woke up from the coma and improved more and more. "After seeing her in a coma, I thought there was no hope left," says mother Rosaria, "but the doctors let her be born a second time. The professionalism and love I found at Cardarelli is something indescribable, something all of us from Campania should be proud of. My daughter was an ordinary patient, they treated her like a queen."
The words of the general manager Giuseppe Longo are addressed not only to the doctors who took care of this extraordinary case, but to all the staff of the Hospital Trust: "Even if the stretcher or the alleged delay in assistance often makes more news - he says - we must never forget that the Cardarelli expresses a very high level of professionalism in the most important branches of medicine. Our goal must be to always improve, but already today this Hospital Trust is a pillar for assistance in Campania and a center of attraction for patients who come from other Regions".
Discharged on September 18, Ilaria will soon celebrate her nineteenth birthday. She will do so with her friends and family who have stood by her side during the most difficult moments. Certainly when she blows out the candles, Ilaria will dedicate a thought to the doctors and nurses who saved her from death less than a month ago, giving her back the hopes and dreams of a healthy young woman.
EDITORIAL TEAM
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