[Adverse effects in children treated with ACTH in infantile spasm]

During a period of ten years, 13 children were treated for infantile spasms with ACTH. Eleven of these developed Cushing-like appearance, 9 irritability, 7 hypokalaemia, 6 metabolic alkalosis, 5 hypertension, 5 infections and 5 osteoporosis. This investigation reveals that osteoporosis is a more frequent side effect than previously recognized and, similarly, that hypertension is also a common side effect. Routine x-ray control of the thoracic spine, regular measurement of blood pressure and control of urinary calcium and serum calcium, phosphate, sodium and potassium are therefore recommended. As cases of ureteronephrolithiasis have also been observed, examination of the urine for blood and ultrasound examination of the kidneys for formation of calculi should also be considered.