Méndez-Abad Paula, Zafra-Rodríguez Pamela
Servicio de Neonatología, Hospital Universitario Puerta del Mar, Cádiz, España.
Arch Argent Pediatr. 2018 Dec 1;116(6):e749-e752. doi: 10.5546/aap.2018.e749.
Hypertrophic cardiomyopathy in the newborn is a rare entity with heterogeneous etiology. Transient forms have been described in children of mothers with gestational diabetes and in preterm infants exposed both to prenatal and postnatal corticosteroids. We report a case of a preterm infant son of a mother who received renal transplant in whom hypertrophic cardiomyopathy was detected. He had been prenatally exposed to corticosteroids and tacrolimus that received the mother as immunosuppressive therapy. Both drugs cross the placental barrier and, on reaching the fetus, could have favored its development. Hypertrophic cardiomyopathy may be an uncommon side effect of treatment with tacrolimus in adults and children and it is reversible upon withdrawal. To our knowledge, it is the first published case of transient hypertrophic cardiomyopathy after fetal exposure to both corticosteroids and tacrolimus in the son of a renal transplanted mother.
新生儿肥厚型心肌病是一种病因异质性的罕见病症。在患有妊娠期糖尿病母亲的子女以及产前和产后均接触过皮质类固醇的早产儿中，曾有过短暂性病例的报道。我们报告了一例早产儿，其母亲接受过肾移植，该患儿被检测出患有肥厚型心肌病。他在产前接触过母亲作为免疫抑制疗法使用的皮质类固醇和他克莫司。这两种药物均可穿过胎盘屏障，进入胎儿体内后，可能促使了该病的发展。肥厚型心肌病可能是他克莫司用于成人和儿童治疗时一种不常见的副作用，停药后可逆转。据我们所知，这是首例关于肾移植母亲的儿子在胎儿期接触皮质类固醇和他克莫司后发生短暂性肥厚型心肌病的报道。
