PROLONGED PROSTAGLANDIN INFUSION AND CORTICAL HYPEROSTOSIS IN AN INFANT WITH CYANOTIC CONGENITAL HEART DISEASE
AbstractProstaglandins (PG) are commonly used in neonates with cyanotic congenital heart diseases to keep the ductus arteriosus patent. The definite treatment for these conditions is surgery. It is occasionally used for longer duration (weeks to months) in preterm babies. Reversible cortical hyperostosis is a relatively recently recognized side effect of prolonged prostaglandin therapy. We describe the case of an infant presenting this complication secondary to prolonged use of PGE1, with typical and extensive radiological findings. The enzymes (prostaglandin 15-OH dehydrogenase & prostaglandin -13 reductase) that catalyze the degradation of prostaglandins are widely distributed in many vascular beds including those of the spleen, kidney, adipose tissue, intestine, liver, testicles and lungs. PGE is normally rapidly inactivated by these tissues, particularly during passage through the lungs.18 However, infants with cyanotic congenital heart diseases that cause decreased pulmonary blood flow and reduced clearance of PGE may have a higher systemic concentration of PGE. In addition, these patients often receive pharmacologic doses of PGE to maintain the patency of the ductus arteriosus. The resultant higher PGE concentration in the blood may result in osseous changes. However the exact mechanism of cortical hyperostosis is not yet known. It may be a direct, dose-related stimulation of osteoblastic cells.
Article Information
49
369-372
306
1155
English
IJPSR
A. Ashraf, U. Saeed , O. Alhadi, Asad-ur-Rehman and S. Iqbal*
Cardiac Imaging Fellow, North West Heart Center, UHSM, Manchester, UK.
drsohailiqbal@yahoo.com
29 April, 2017
16 August, 2017
17 September, 2017
10.13040/IJPSR.0975-8232.9(1).369-72
01 January, 2018