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Cortical hyperostosis simulating osteomyelitis after short-term prostaglandin E1 infusion
A K Kalloghlian1, H H Frayha, M M deMoor
1Department of Paediatrics, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.
Insights
A newborn with congenital heart disease developed severe bone changes and high alkaline phosphatase during prostaglandin E1 (PGE1) therapy. Symptoms resolved after stopping PGE1, but enzyme levels remained elevated, highlighting a rare complication.
Area of Science:
- Pediatric Cardiology
- Neonatology
- Pediatric Endocrinology
Background:
- Cyanotic congenital heart disease necessitates interventions like prostaglandin E1 (PGE1) infusion for ductal patency.
- PGE1 is crucial for maintaining systemic circulation in neonates with specific cardiac defects.
Observation:
- A neonate receiving PGE1 infusion for cyanotic heart disease developed severe cortical hyperostosis.
- This bone condition mimicked osteomyelitis and was associated with markedly elevated alkaline phosphatase levels.
Findings:
- The hyperostosis and associated symptoms resolved within six days of discontinuing PGE1.
- Alkaline phosphatase levels remained elevated despite the resolution of clinical signs and discontinuation of PGE1.
Implications:
- This case highlights a potential acute complication of prostaglandin E1 therapy in neonates.
- The findings suggest a need for monitoring bone metabolism and alkaline phosphatase during PGE1 treatment.
Unlabelled:
We describe a newborn with cyanotic congenital heart disease who developed severe cortical hyperostosis of his long bones simulating osteomyelitis with remarkable elevation of alkaline phosphatase on the 11th day of prostaglandin E1 (PGE1) infusion. Soft tissue swelling and tenderness disappeared 6 days after discontinuation of PGE1, however alkaline phosphatase remained high.
Conclusion:
To our knowledge this is the first reported case that presented with such an acute complication of PGE1 therapy within a short period.
