Cesarino Romano

Biography

• Born on July 5, 1924 in Voghera, Italy
• 1952 – Graduated in Medicine, University of Pavia
• 1957 – Directed the Section for the study of Cystic Fibrosis of the Pediatric Clinic
• 1958 – Appointed Paediatrician, University of Genoa; directed the cardiology department; head of  Electrocardiography Laboratory and the Cardiology Section of the Pediatric Clinic
• 1960 – Director of the Center for Social Pediatrics for Endocrine-Metabolic Diseases of the University of Genoa
• 1963 – Described a new familial congenital arrhythmia; reported for the first time in the international medical literature – a new electrocardiographic sign present in hypothyroidism and hypercalcemia.
• 1966 – Inspired and contributed to the establishment dell’Associazione Italiana per la Lotta contro la Fibrosi Cistica
• 1972 – Appointed Professor of Paediatrics
• 1985 – In collaboration with Afzelius and Gargani he described a new variant of primitive ciliary dyskinesia
• 1976-1996 Director of Paediatric department, University of Genoa
• Died on April 23, 2008

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

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’.

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.

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.
• Bibliography. Romano, Cesarino. WorldCat Identities

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

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