{"id":2116,"date":"2022-07-22T16:54:14","date_gmt":"2022-07-22T14:54:14","guid":{"rendered":"https:\/\/t21learning.institutlejeune.org\/?p=2116"},"modified":"2023-11-22T17:28:13","modified_gmt":"2023-11-22T16:28:13","slug":"pulmonary-hemosiderosis-and-mucoviscidosis","status":"publish","type":"post","link":"https:\/\/t21learning.institutlejeune.org\/en\/pulmonary-hemosiderosis-and-mucoviscidosis\/","title":{"rendered":"Pulmonary Hemosiderosis and Mucoviscidosis"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-post\" data-elementor-id=\"2116\" class=\"elementor elementor-2116\" data-elementor-post-type=\"post\">\n\t\t\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-d1243aa elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"d1243aa\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-c97ba5e\" data-id=\"c97ba5e\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-d376850 elementor-widget elementor-widget-text-editor\" data-id=\"d376850\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><strong>RESPIRATORY PATHOLOGIES<\/strong><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-29977f6 elementor-widget elementor-widget-heading\" data-id=\"29977f6\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Pulmonary Hemosiderosis and Mucoviscidosis<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-2673912 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"2673912\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-66 elementor-top-column elementor-element elementor-element-637cd68\" data-id=\"637cd68\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-dcb356f elementor-widget elementor-widget-image\" data-id=\"dcb356f\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<img fetchpriority=\"high\" decoding=\"async\" width=\"932\" height=\"572\" src=\"https:\/\/t21learning.institutlejeune.org\/wp-content\/uploads\/2022\/03\/Pathologies_respiratoires_rares_associees.jpeg\" class=\"attachment-large size-large wp-image-2113\" alt=\"\" srcset=\"https:\/\/t21learning.institutlejeune.org\/wp-content\/uploads\/2022\/03\/Pathologies_respiratoires_rares_associees.jpeg 932w, https:\/\/t21learning.institutlejeune.org\/wp-content\/uploads\/2022\/03\/Pathologies_respiratoires_rares_associees-300x184.jpeg 300w, https:\/\/t21learning.institutlejeune.org\/wp-content\/uploads\/2022\/03\/Pathologies_respiratoires_rares_associees-768x471.jpeg 768w\" sizes=\"(max-width: 932px) 100vw, 932px\" \/>\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-33 elementor-top-column elementor-element elementor-element-7d5f108\" data-id=\"7d5f108\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-ba8a064 elementor-widget elementor-widget-toggle\" data-id=\"ba8a064\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"toggle.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-toggle\">\n\t\t\t\t\t\t\t<div class=\"elementor-toggle-item\">\n\t\t\t\t\t<div id=\"elementor-tab-title-1951\" class=\"elementor-tab-title\" data-tab=\"1\" role=\"button\" aria-controls=\"elementor-tab-content-1951\" aria-expanded=\"false\">\n\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon elementor-toggle-icon-left\" aria-hidden=\"true\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon-closed\"><i class=\"fas fa-caret-right\"><\/i><\/span>\n\t\t\t\t\t\t\t\t<span class=\"elementor-toggle-icon-opened\"><i class=\"elementor-toggle-icon-opened fas fa-caret-up\"><\/i><\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t<a class=\"elementor-toggle-title\" tabindex=\"0\">CHAPTER OUTLINE<\/a>\n\t\t\t\t\t<\/div>\n\n\t\t\t\t\t<div id=\"elementor-tab-content-1951\" class=\"elementor-tab-content elementor-clearfix\" data-tab=\"1\" role=\"region\" aria-labelledby=\"elementor-tab-title-1951\"><p><a href=\"https:\/\/t21learning.institutlejeune.org\/en\/general-overview-of-respiratory-pathologies-in-trisomy-21\/\" target=\"_blank\" rel=\"noopener\">1- General overview<\/a><\/p><p>\u00a0<\/p><p><a href=\"https:\/\/t21learning.institutlejeune.org\/en\/non-infectious-respiratory-pathologies-of-the-upper-airways\/\" target=\"_blank\" rel=\"noopener\">2- Non-Infectious Respiratory Pathologies of the Upper Airways<\/a><\/p><p>\u00a0<\/p><p><a href=\"https:\/\/t21learning.institutlejeune.org\/en\/non-infectious-pathologies-of-the-lungs-and-lower-airways\/\" target=\"_blank\" rel=\"noopener\">3- Non-Infectious Pathologies of the Lungs and Lower Airways<\/a><\/p><p>\u00a0<\/p><p><a href=\"https:\/\/t21learning.institutlejeune.org\/en\/infectious-respiratory-pathologies-of-the-upper-airways\/\" target=\"_blank\" rel=\"noopener\">4- Infectious Respiratory Pathologies of the Upper Airways<\/a><\/p><p>\u00a0<\/p><p><a href=\"https:\/\/t21learning.institutlejeune.org\/en\/lower-respiratory-tract-infections-in-individuals-with-trisomy-21\/\">5- Lower respiratory tract infections<\/a><\/p><p>\u00a0<\/p><p><a href=\"https:\/\/t21learning.institutlejeune.org\/en\/preventing-respiratory-tract-infections-rtis\/\" target=\"_blank\" rel=\"noopener\">6- Preventing respiratory tract infections<\/a><\/p><p>\u00a0<\/p><p><a href=\"https:\/\/t21learning.institutlejeune.org\/en\/obstructive-sleep-apnea-syndrome-osas\/\">7- Obstructive sleep apnea syndrome<\/a><\/p><p>\u00a0<\/p><p><a href=\"https:\/\/t21learning.institutlejeune.org\/en\/central-sleep-apnea-alveolar-hypoventilation-and-hypoxemia\/\">8- Central Sleep Apnea, Alveolar Hypoventilation, and Hypoxemia<\/a><\/p><p>\u00a0<\/p><p><strong><a href=\"https:\/\/t21learning.institutlejeune.org\/en\/pulmonary-hemosiderosis-and-mucoviscidosis\/\">9- Pulmonary Hemosiderosis and Mucoviscidosis<\/a><\/strong><\/p><\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-122386f elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"122386f\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-8ad00be\" data-id=\"8ad00be\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-f8c47a1 elementor-widget elementor-widget-text-editor\" data-id=\"f8c47a1\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>Whether simply associated with trisomy 21, such as mucoviscidosis (cystic fibrosis), or a genuine comorbidity, such as pulmonary hemosiderosis, although these two lung pathologies are rare \u2013 indeed very rare \u2013 they need to be thoroughly understood.<\/p><p>\u00a0<\/p><p>In the video and accompanying technical sheet, Dr. Herv\u00e9 Walti, a pediatrician at the J\u00e9r\u00f4me Lejeune Institute, tells you more.\u00a0 He talks about their often atypical forms of presentation \u2013 which can potentially delay diagnosis \u2013 their often more severe progression, and finally their management, which should have the same treatment opportunities as neurotypical patients.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-f16d585 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"f16d585\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-3905d11\" data-id=\"3905d11\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-7143697 elementor-widget elementor-widget-video\" data-id=\"7143697\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;youtube_url&quot;:&quot;https:\\\/\\\/youtu.be\\\/tnZTa1f7Kks&quot;,&quot;video_type&quot;:&quot;youtube&quot;,&quot;controls&quot;:&quot;yes&quot;}\" data-widget_type=\"video.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-wrapper elementor-open-inline\">\n\t\t\t<div class=\"elementor-video\"><\/div>\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-fd5b6a5 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"fd5b6a5\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-3ae44db\" data-id=\"3ae44db\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-564a1a6 elementor-widget elementor-widget-spacer\" data-id=\"564a1a6\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"spacer.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-spacer\">\n\t\t\t<div class=\"elementor-spacer-inner\"><\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-6916cef elementor-align-center elementor-widget elementor-widget-button\" data-id=\"6916cef\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"button.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<div class=\"elementor-button-wrapper\">\n\t\t\t\t\t<a class=\"elementor-button elementor-button-link elementor-size-sm\" href=\"https:\/\/t21learning.institutlejeune.org\/wp-content\/uploads\/2023\/08\/2.9-Rare-Lung-Diseases-associated-with-Down-Syndrome-EN.pdf\" target=\"_blank\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t\t\t\t<span class=\"elementor-button-text\">Download the Summary Sheet<\/span>\n\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/a>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-40fca90 elementor-widget elementor-widget-shortcode\" data-id=\"40fca90\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"shortcode.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-shortcode\"><div class=\"_df_book df-lite\" id=\"df_3048\"  _slug=\"2-9-pulmonary-hemosiderosis-and-mucoviscidosis-_-eng\" data-title=\"2-9-pulmonary-hemosiderosis-and-mucoviscidosis-_-eng\" wpoptions=\"true\" thumbtype=\"\" ><\/div><script class=\"df-shortcode-script\" nowprocket type=\"application\/javascript\">window.option_df_3048 = {\"outline\":[],\"autoEnableOutline\":\"false\",\"autoEnableThumbnail\":\"false\",\"overwritePDFOutline\":\"false\",\"direction\":\"1\",\"pageSize\":\"0\",\"source\":\"https:\\\/\\\/t21learning.institutlejeune.org\\\/wp-content\\\/uploads\\\/2022\\\/07\\\/9.-Pathologies-respiratoires-rares-associees_EN-relu.pdf\",\"wpOptions\":\"true\"}; if(window.DFLIP && window.DFLIP.parseBooks){window.DFLIP.parseBooks();}<\/script>\n<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-2570084 elementor-widget elementor-widget-spacer\" data-id=\"2570084\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"spacer.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-spacer\">\n\t\t\t<div class=\"elementor-spacer-inner\"><\/div>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-d18d5d5 elementor-align-justify btn-refs elementor-widget elementor-widget-button\" data-id=\"d18d5d5\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"button.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<div class=\"elementor-button-wrapper\">\n\t\t\t\t\t<a class=\"elementor-button elementor-button-link elementor-size-sm\" href=\"#\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t\t\t\t<span class=\"elementor-button-text\">See references<\/span>\n\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/a>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<section class=\"elementor-section elementor-inner-section elementor-element elementor-element-6bc2cbf div-refs div-refs-closed elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"6bc2cbf\" data-element_type=\"section\" data-e-type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-inner-column elementor-element elementor-element-ca7d46e\" data-id=\"ca7d46e\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-126ef16 elementor-widget elementor-widget-text-editor\" data-id=\"126ef16\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<ul><li>Alimi A, Taytard J, Abou Taam R, Houdouin V, Forgeron A, Lubrano Lavadera M, Cros P, Gibertini I, Derelle J, Deschildre A, Thumerelle C, Epaud R, Reix P, Fayon M, Roullaud S, Troussier F, Renoux MC, de Blic J, Leyronnas S, Thouvenin G, Perisson C, Ravel A, Clement A, Corvol H, Nathan N; French RespiRare\u00ae group. Pulmonary hemosiderosis in children with Down syndrome: a national experience. Orphanet J Rare Dis. 2018 Apr 20;13(1):60. doi: 10.1186\/s13023-018-0806-6. PMID: 29678139; PMCID: PMC5910623.<\/li><li>Bear CE. A Therapy for Most with Cystic Fibrosis. Cell. 2020 Jan 23;180(2):211. doi: 10.1016\/j.cell.2019.12.032. PMID: 31978337.<\/li><li>Bloom JL, Frank B, Weinman JP, Galambos C, O&#8217;Leary ST, Liptzin DR, Fuhlbrigge RC. Diffuse alveolar hemorrhage in children with trisomy 21. Pediatr Rheumatol Online J. 2021 Jul 17;19(1):114. doi: 10.1186\/s12969-021-00592-4. PMID: 34273981; PMCID: PMC8285855.<\/li><li>Bush D, Abman SH, Galambos C. Prominent Intrapulmonary Bronchopulmonary Anastomoses and Abnormal Lung Development in Infants and Children with Down Syndrome. J Pediatr. 2017 Jan;180:156-162.e1. doi: 10.1016\/j.jpeds.2016.08.063. Epub 2016 Sep 22. PMID: 27666181.<\/li><\/ul><ul><li>Bush D, Galambos C, Dunbar Ivy D. Pulmonary hypertension in children with Down syndrome. Pediatr Pulmonol. 2021 Mar;56(3):621-629. doi: 10.1002\/ppul.24687. Epub 2020 Feb 12. PMID: 32049444.<\/li><li>Charbek E, Kamel G, Nayak RP. Ivacaftor for the Treatment of Cystic Fibrosis Coexisting with Trisomy 21: A Case Report. Cureus. 2019 Nov 18;11(11):e6179. doi: 10.7759\/cureus.6179. PMID: 31890385; PMCID: PMC6919948.<\/li><\/ul>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-inner-column elementor-element elementor-element-ad60c6e\" data-id=\"ad60c6e\" data-element_type=\"column\" data-e-type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-1bffc94 elementor-widget elementor-widget-text-editor\" data-id=\"1bffc94\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<ul><li>Galambos C, Minic AD, Bush D, Nguyen D, Dodson B, Seedorf G, Abman SH. Increased Lung Expression of Anti-Angiogenic Factors in Down Syndrome: Potential Role in Abnormal Lung Vascular Growth and the Risk for Pulmonary Hypertension. PLoS One. 2016 Aug 3;11(8):e0159005. doi: 10.1371\/journal.pone.0159005. PMID: 27487163; PMCID: PMC4972384.<\/li><li>Guy EL, Peckham DG, Brownlee KG, Conway SP, Lee TW. Cystic fibrosis co-existing with trisomy 21. J Cyst Fibros. 2010 Sep;9(5):330-1. doi: 10.1016\/j.jcf.2010.05.003. Epub 2010 Jun 11. PMID: 20538528.<\/li><li>Milunsky A. Cystic fibrosis and Down&#8217;s syndrome. Pediatrics. 1968 Sep;42(3):501-4. PMID: 4234128.<\/li><li>Ruf K, Demerath A, Hebestreit H, Kunzmann S. Is sweat testing for cystic fibrosis feasible in patients with down syndrome? BMC Pulm Med. 2018 Jan 16;18(1):8. doi: 10.1186\/s12890-018-0580-1. PMID: 29338740; PMCID: PMC5771200.<\/li><li>Tobai H, Yano J, Sato N, Amanuma F, Takahashi M, Endo M, Ishimura M, Ohga S, Maruyama H. Successful Liposteroid Therapy for a Recurrent Idiopathic Pulmonary Hemosiderosis with Down Syndrome. Case Rep Pediatr. 2020 Apr 25;2020:5292947. doi: 10.1155\/2020\/5292947. PMID: 32373381; PMCID: PMC7197000.<\/li><\/ul>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<div class=\"elementor-element elementor-element-1978eb5 elementor-widget elementor-widget-html\" data-id=\"1978eb5\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"html.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<script>\n    jQuery(\".btn-refs\").on(\"click\", function(e){\n        e.preventDefault()\n        jQuery(\".div-refs\").toggleClass(\"div-refs-closed\")\n    })\n<\/script>\n\n<style>\nbody:not(.elementor-editor-active) .div-refs{\n    transition: 0.3s;\n    max-height: 1000px;\n}\n    body:not(.elementor-editor-active) .div-refs-closed{\n        max-height: 0;\n        overflow: hidden !important;\n    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