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[Two cases of myocarditis appearing during ACTH therapy for infantile spasms]
M Urashima1, M Akashi, F Kawame
1Department of Pediatrics, Tokyo Metropolitan Kita Medical Rehabilitation Center for the Handicapped.
Abstract:
We experienced two cases of myocarditis occurring during ACTH therapy for infantile spasms. Myocarditis cases occurred during the reduction of ACTH doses, and viral infection was suspected. Steroid replacement therapy was effective in the both cases. It is important to consider that ACTH therapy for infantile spasms could sometimes lead to severe myocarditis.
Insights
Adrenocorticotropic hormone (ACTH) therapy for infantile spasms can rarely cause severe myocarditis, particularly during dose reduction. Steroid replacement therapy proved effective in managing these cases.
Area of Science:
- Pediatric Neurology
- Cardiology
- Endocrinology
Background:
- Infantile spasms are a severe form of epilepsy in infants.
- Adrenocorticotropic hormone (ACTH) therapy is a common treatment for infantile spasms.
- Myocarditis is inflammation of the heart muscle.
Observation:
- Two cases of myocarditis were observed in infants undergoing ACTH therapy for infantile spasms.
- Myocarditis occurred during the tapering phase of ACTH treatment.
- Viral infection was suspected as a potential trigger for myocarditis.
Findings:
- ACTH therapy, while effective for infantile spasms, carries a risk of severe cardiac complications.
- Myocarditis associated with ACTH therapy can manifest during dose reduction.
- Steroid replacement therapy demonstrated efficacy in resolving myocarditis in these patients.
Implications:
- Clinicians should be vigilant for cardiac adverse events during ACTH therapy for infantile spasms.
- Monitoring for myocarditis is crucial, especially when reducing ACTH dosage.
- Early recognition and appropriate management, including steroid replacement, are vital for favorable outcomes.