Lang D, Mühler E, Kupferschmid C, Tacke E, von Bernuth G
Eur J Pediatr. 1984 Jun;142(2):121-5. doi: 10.1007/BF00445591.
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.
通过脑电图和临床状况的改善来评估促肾上腺皮质激素（ACTH）在儿童癫痫治疗中的效用。然而，必须面对明显的副作用，甚至是严重的副作用。最常见的并发症是库欣综合征、感染和动脉高血压。我们报告了7例婴儿肌阵挛性癫痫患者，他们在ACTH治疗期间出现心肌肥厚且左心室功能增强。这些变化通过系列超声心动图检查得以检测和跟踪。在ACTH治疗终止后的5个月内，超声心动图异常表现消失。我们认为心脏肥大是由ACTH诱发的。基于ACTH的各种生物学效应，提出了不同的解释：心肌组织中的水肿或糖原沉积、高胰岛素血症、动脉高血压和增强的变力刺激。基于我们的观察结果，我们建议通过进行系列超声心动图检查来仔细监测接受ACTH治疗的儿童。
