Cesarino Romano

Biography

• 1924 – Born July 5 in Voghera, Italy.
• 1952 – Graduated with honours in Medicine and Surgery from the University of Pavia; admitted on merit to Collegio Ghislieri.
• 1954 – Earned Pediatric Specialization in Genoa with a thesis on pancreatic pathology and cystic fibrosis in children.
• 1956 – Began directing the Pediatric Clinic’s outpatient cardiology services in Genoa. Awarded the Guigoz international fellowship; trained at Hôpital des Enfants Malades, Paris, under Prof. Pierre Royer.
• 1957 – Headed the Section for the Study of Cystic Fibrosis at the Genoa Pediatric Clinic.
• 1958 – Appointed Paediatrician at the University of Genoa; led the ECG Lab and Cardiology Section.
• 1960 – Director of the Center for Social Pediatrics for Endocrine-Metabolic Diseases of the University of Genoa
• 1961 – Organised the first Italian Symposium on Pancreatic Cystic Fibrosis in Genoa. Earned Libera Docenza in Pediatrics for scientific merit.
• 1963 – Described Romano-Ward Syndrome, a familial congenital long QT syndrome; first report of a new ECG sign in hypothyroidism and hypercalcemia.
• 1965 – Led Section for Phenylketonuria; began pioneering neonatal screening programs in Italy.
• 1966 – Inspired and contributed to the establishment dell’Associazione Italiana per la Lotta contro la Fibrosi Cistica; became first Secretary of the Scientific Advisory Committee.
• 1968 – Published the first Italian monograph on cystic fibrosis.
• 1972 – Appointed Professor of Paediatrics (Systematic Pediatric Therapy).
• 1973 – Organised Symposium on Chronic and Recurrent Bronchopneumopathies; Liguria passed Italy’s first regional law on neonatal screening for phenylketonuria.
• 1976 – Became Full Professor and Director of the Pediatric Clinic, University of Genoa; established Italy’s first pediatric echocardiography lab in Liguria.
• 1985 – Co-described a new variant of primitive ciliary dyskinesia with Afzelius and Gargani
• 1986 – Nationwide expansion of neonatal screening to congenital hypothyroidism.
• 1990 – Oversaw Italy’s first lung transplant in a cystic fibrosis patient.
• 1994 – Co-organised the first international symposium on limb lengthening in Tel Aviv with Zvi Laron and Silvano Mastragostino.
• 1996 – Retired from Directorship of the Pediatric Clinic at the University of Genoa.
• 2000s – Developed Emergency Pediatrics in Italy; founded postgraduate course and authored Italy’s first textbook on the subject – Pediatria d’urgenza.
• 2008 – Died April 23 in Genoa, aged 83.

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Medical Eponyms

Romano-Ward Syndrome (1963)

Congenital (autosomal dominant) long QT syndrome (LQTS). Unlike Jervell-Lange-Nielsen syndrome, there is no congenital hearing loss present. Multiple genetic mutations identified linked to cardiac potassium and beta-adrenergic channels.

Independently described in 1963 by Cesarino Romano and by Irish paediatrician Owen Conor Ward (1923-2021). Both reported an autosomal dominant long-term QT syndrome, later known as Romano-Ward syndrome.

Romano described an inherited functional syncopal heart disorder with prolonged QT interval in a 3-month-old female patient (“Aritmie cardiache rare dell’eta’pediatrica”). During one syncopal attack, her ECG demonstrated VF. Between attacks, QT interval prolongation, broad diphasic T-waves and abnormal alternate complexes were repeatedly shown. Two brothers of his patient had exhibited the same symptoms and died suddenly, one at 44 days and one at 4 months of age.

In Romano’s case report in The Lancet, he identified the difference between this new condition and Jervell and Lange-Nielsen syndrome, and connects his findings with Owen Ward’s description of a similar case.

We pointed to the resemblance between our case and the syndrome of deaf-mutism, syncopal attacks, lengthening of the QT interval, and sudden death, but, as in Ward’s case, there was no evidence of deaf-mutism in our patient or in her family. The syndrome reported by us and by
Ward may be a distinct entity.

Romano, 1965

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Key Medical Contributions

Neonatal Screening Pioneer: Spearheaded Italy’s first regional law (Liguria, 1973) for newborn screening of phenylketonuria. Expanded to congenital hypothyroidism (1986) and cystic fibrosis (1997); formalised nationally in 1999. Founder and first president of the Italian Society for Neonatal Screening (SISN).

Cystic Fibrosis Leadership: Led Genoa’s Regional CF Centre and organised Italy’s first CF symposium (1961). Published foundational Italian monograph in 1968 and oversaw the country’s first CF lung transplant in 1990.

Pediatric Emergency Medicine: Established Italy’s first postgraduate course in Emergency Pediatrics in the early 2000s. Authored the first Italian textbook on the subject (Pediatria d’urgenza), laying groundwork for national training standards.

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Controversies

Romano and Ward are forever bound by their eponym but did they get on? The answer is yes! Ward recently speaking of Romano said ‘We remained good friends until his death’.

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Major Publications

• Romano C, Gemme G, Pongiglione R. Aritmie cardiache rare dell’eta pediatrica. [Rare cardiac arrhythmia of the pediatric age II, syncopal attacks due to paroxysmal ventricular fibrillation]. Clin Pediatr (Bologna) 1963;45:656–683.
• Romano C, Gemme G, Pongiglione R. Aritmie cardiache rare dell’eta pediatrica. [Rare cardiac arrythmias of the pediatric age. I. Repetitive paroxysmal tachycardia]. Minerva Pediatr. 1963 Nov 3;15:1155-64
• Romano C, Gemme G, Raffaelli E. Studio elettrocardiografico del mixedema congenito. (Particolare interesse di una fase terminale di “tipo ipercalcemico”) [electrocardiographic study of congenital myxedema. (special importance of a terminal phase of hypercalcemic type)]. minerva pediatr. 1963 jun;15:655-69.
• Romano C. Congenital Cardiac Arrhythmia. Lancet 1965; 285(7386): 658-9
• Romano C. Guida alla diagnosi ed al trattamento della fibrosi cistica: mucoviscidosi. 1970
• Romano C. La fibrosi cistica. 1972
• Romano C. Atti Simposio Nazionale su broncopneumopatie croniche e ricorrenti dell’età pediatrica: Genova 5-6 maggio 1973.
• Afzelius BA, Gargani G, Romano C. Abnormal length of cilia as a possible cause of defective mucociliary clearance. Eur J Respir Dis. 1985 Mar;66(3):173-80.
• Lorini R, Di Pietro P, Romano C. Pediatria d’urgenza. Elsevier 2005.

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References

Biography

• Farnetani I, Farnetani F. La top twelve della ricerca pediatrica italiana (una “spigolatura storica”) [The top twelve most important discoveries made by Italian pediatric researchers]. Minerva Pediatr. 2015 Oct;67(5):437-50.

Eponymous terms

• Hodkinson EC, Hill AP, Vandenberg JI. The Romano-Ward syndrome – 1964 – 2014: 50 years of progress. Irish Medical Journal 2014; 107(4): 122-4.
• Eponymythology. History of the Electrocardiogram. LITFL