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[Hypertrophic cardiomyopathy during adrenocorticotrophic hormone administration in infants: a case report]
M Pala1, L Cassisa, G Di Girolamo
1Istituto di Clinica Medica Generale e Terapia Medica, Università degli Studi, Sassari.
Insights
Adrenocorticotropic hormone (ACTH) therapy in infants may cause hypertrophic cardiomyopathy and heart failure. Prompt treatment with propranolol and ACTH withdrawal resolved cardiac issues, highlighting the need for cardiac monitoring during ACTH use.
Area of Science:
- Pediatric Cardiology
- Neonatal Neurology
- Endocrinology
Background:
- Infantile myoclonic seizures are a severe epilepsy syndrome in infants.
- Adrenocorticotropic hormone (ACTH) therapy is used for infantile spasms but carries potential side effects.
- Hypertrophic cardiomyopathy is a condition characterized by thickening of the heart muscle.
Observation:
- A 2-month-old infant receiving ACTH therapy for infantile myoclonic seizures developed congestive heart failure.
- The heart failure was secondary to hypertrophic cardiomyopathy.
- Two-dimensional echocardiography confirmed cardiac hypertrophy.
Findings:
- Treatment with propranolol and discontinuation of ACTH therapy led to the resolution of hypertrophic cardiomyopathy.
- This suggests a potential link between ACTH administration and the development of cardiac hypertrophy in infants.
- Careful cardiac monitoring is essential during ACTH therapy.
Implications:
- This case highlights a critical, previously under-recognized adverse effect of ACTH therapy in neonates.
- It underscores the importance of vigilant echocardiographic monitoring for cardiac abnormalities in infants undergoing ACTH treatment.
- Early detection and intervention can prevent severe cardiac complications.
Abstract:
We report a 2-month-old child with infantile myoclonic seizures, who developed congestive heart failure secondary to hypertrophic cardiomyopathy while receiving adrenocorticotropic hormone (ACTH) therapy. Treatment with propranolol and withdrawal of ACTH led to the resolution of cardiac hypertrophy as determined by two-dimensional echocardiography. Possible links between ACTH therapy and the development of hypertrophic cardiomyopathy are examined. Our report confirms that a careful monitoring is required to detect cardiac abnormalities during ACTH administration.