Cardiac hypertrophy secondary to ACTH treatment in children

The usefulness of ACTH in the treatment of childhood epilepsy is assessed by improvement in the EEG and in the clinical condition. However, pronounced side effects, even serious ones, must be encountered. The most common complications are Cushing syndrome, infections, and arterial hypertension. We r...

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Bibliographic Details
Published in:European journal of pediatrics 1984-06, Vol.142 (2), p.121-125
Main Authors: LANG, D, MÜHLER, E, KUPFERSCHMID, C, TACKE, E, VON BERNUTH, G
Format: Article
Language:English
Subjects:
Adrenocorticotropic Hormone - adverse effects
Biological and medical sciences
Cardiomegaly - chemically induced
Child, Preschool
Drug toxicity and drugs side effects treatment
Echocardiography
Epilepsy - drug therapy
Humans
Infant
Medical sciences
Pharmacology. Drug treatments
Toxicity: blood
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Summary:The usefulness of ACTH in the treatment of childhood epilepsy is assessed by improvement in the EEG and in the clinical condition. However, pronounced side effects, even serious ones, must be encountered. The most common complications are Cushing syndrome, infections, and arterial hypertension. We report on seven patients with infantile myoclonic seizures, who exhibited myocardial hypertrophy with increased left ventricular function during ACTH treatment. These changes were detected and followed by serial echocardiographic investigations. Within a period of 5 months after the termination of ACTH therapy the abnormal echocardiographic findings disappeared. We believe that the cardiac hypertrophy is ACTH-induced. Based on the various biological effects of ACTH different explanations are proposed: oedema or deposition of glycogen in the myocardial tissue, hyperinsulinism, arterial hypertension and increased inotropic stimulus. Because of our observations, we suggest careful monitoring of children treated with ACTH by performing serial echocardiographic investigations.
ISSN:0340-6199
1432-1076
DOI:10.1007/bf00445591