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Priapism in an infant with sickle cell trait after cardiac transplant
Chasta-Dawne Bacsu1, Peter D Metcalfe
1Division of Urology, University of Alberta, Edmonton, Alberta, Canada.
Insights
A case study found that a 6-month-old boy experienced prolonged erections after receiving intravenous sildenafil for pulmonary hypertension post-cardiac transplant. The sickle cell trait may have contributed to this side effect.
Area of Science:
- Pediatric Cardiology
- Pharmacology
- Genetics
Background:
- A 6-month-old boy underwent orthotopic cardiac transplantation after receiving a Berlin heart.
- Postoperative pulmonary hypertension necessitated treatment with intravenous sildenafil, a phosphodiesterase-5 inhibitor.
- The patient required multiple transfusions during pre-, peri-, and postoperative care.
Purpose of the Study:
- To report a case of priapism in an infant treated with sildenafil.
- To investigate potential contributing factors to priapism in this patient.
- To highlight the side effect profile of sildenafil in pediatric cardiac patients.
Main Methods:
- Case report of a 6-month-old boy of African descent.
- Clinical observation of prolonged, semitumescent erections.
- Genetic testing for sickle cell trait.
- Review of medication and medical history.
Main Results:
- The patient developed recurrent prolonged erections (30-180 minutes) during intravenous sildenafil therapy.
- Erections resolved spontaneously without urologic intervention.
- The patient was identified as a carrier of the sickle cell gene.
Conclusions:
- Sildenafil use in conjunction with the sickle cell trait may be linked to priapism in pediatric patients.
- This case highlights a potential adverse effect of sildenafil in infants post-cardiac surgery.
- Further research is needed to understand the interaction between sildenafil and sickle cell trait in children.
Abstract:
We report a case of priapism in a 6-month-old boy of African descent who had been receiving intravenous sildenafil, a phosphodiesterase-5 inhibitor. An orthotopic cardiac transplantation had been performed at 6 months of age, 2 months after he had received a Berlin heart. The pre-, peri-, and postoperative care required multiple transfusions, and postoperative pulmonary hypertension required treatment with intravenous sildenafil. He developed a series of prolonged, semitumescent erections (30-180 minutes) that resolved spontaneously without the need for urologic intervention. Subsequent investigations revealed he was a carrier of a sickle cell gene. Although the precise etiology of the prolonged penile erection is unclear, it was likely secondary to the use of sildenafil and the sickle cell trait.
