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Hypofibrinogenemia caused by adrenocorticotropic hormone for infantile spasms: a case report

Atsushi Kamei1, Nami Araya1, Manami Akasaka1

  • 1Department of Pediatrics, Iwate Medical University School of Medicine, Morioka, Iwate, Japan.

Brain & Development
|April 17, 2014
PubMed

Insights

Adrenocorticotropic hormone (ACTH) therapy for infantile spasms can cause hypofibrinogenemia, a dangerous drop in fibrinogen levels. Monitor fibrinogen during ACTH treatment and stop if levels fall below 60.0 mg/dL.

Area of Science:

  • Pediatric Neurology
  • Hematology
  • Pharmacology

Background:

  • Infantile spasms are a severe form of epilepsy in infants.
  • Adrenocorticotropic hormone (ACTH) therapy is a common treatment for infantile spasms.
  • Hypofibrinogenemia is a condition characterized by abnormally low levels of fibrinogen in the blood.

Observation:

  • A 7-month-old boy undergoing ACTH therapy for infantile spasms developed hypofibrinogenemia.
  • The patient's fibrinogen level dropped to 66.6 mg/dL, significantly below the reference range of 170-405 mg/dL.
  • No clinical signs of bleeding diathesis were observed in the patient.

Findings:

  • ACTH therapy can lead to a significant decrease in plasma fibrinogen levels.
  • Hypofibrinogenemia during ACTH therapy may occur even without overt bleeding.
  • Hemostatic levels of fibrinogen are considered to be above 60.0 mg/dL.

Implications:

  • Plasma fibrinogen levels should be routinely monitored in patients receiving ACTH therapy.
  • Discontinuation of ACTH therapy is recommended if fibrinogen levels fall below hemostatic levels or if bleeding tendencies arise.
  • This case highlights a potential adverse effect of ACTH therapy that requires clinical vigilance and monitoring.

Keywords:
Adrenocorticotropic hormone therapyHypofibrinogenemiaInfantile spasms

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