Young R S, Fripp R R, Stern D R, Darowish C
Department of Pediatrics, Yale University School of Medicine, New Haven, CT 06510.
J Child Neurol. 1987 Oct;2(4):311-2. doi: 10.1177/088307388700200417.
Hypertrophic cardiomyopathy is a newly recognized, potentially fatal complication of ACTH therapy. We report the clinical, echocardiographic, and pathologic findings of an infant who was treated with ACTH for seizure disorder and subsequently developed severe systemic hypertension. Echocardiography revealed marked cardiac hypertrophy with disproportionate septal hypertrophy. Decreasing the dose of ACTH reduced the systemic blood pressure, but the cardiac hypertrophy progressed and the child subsequently died. Children who develop hypertension during ACTH therapy should be considered at risk for hypertrophic cardiomyopathy and should undergo routine echocardiographic evaluation.
肥厚型心肌病是促肾上腺皮质激素（ACTH）治疗新发现的一种潜在致命并发症。我们报告了一名患有癫痫障碍接受ACTH治疗后出现严重系统性高血压婴儿的临床、超声心动图和病理学检查结果。超声心动图显示显著的心肌肥厚，室间隔肥厚不成比例。减少ACTH剂量可降低系统性血压，但心肌肥厚仍进展，患儿随后死亡。接受ACTH治疗期间发生高血压的儿童应被视为有患肥厚型心肌病的风险，应接受常规超声心动图评估。
