Side-effects of long-term prostaglandin E(1) treatment in neonates.
BACKGROUND
In some neonates suffering from ductus arteriosus dependent congenital heart defect, a Prostaglandin E(1) (PGE1) therapy longer than 2 weeks may be needed. However, PGE1 analogue compounds may produce several adverse effects.


METHODS
The authors retrospectively analyzed the data of nine patients who underwent a PGE1 treatment lasting longer than 14 days.


RESULTS
The leukocyte count of the patients remained high throughout the treatment period, and the proportion of neutrophils was over 50%. Transient feeding difficulty and abdominal distension, and possible signs of gastric-outlet obstruction, were observed in two cases. In the case of three patients, cortical hyperostosis developed after different cumulative doses (1584, 3384 and 4320 microg). Significant correlations were found between the doses of PGE1 and serum K(+) levels (r=-0.770, P < 0.05) and between the blood standard bicarbonate levels and PGE1 doses (r= 0.889, P < 0.01). Bartter syndrome-like condition developed in those three patients who received the largest cumulative doses.


CONCLUSIONS
Fluid-electrolyte parameters must be controlled frequently in the case of each patient treated with PGE1 for longer than 2 weeks. Although the dose, the length of the therapy and individual susceptibility may be equally important, fluid-electrolyte disturbances and the development of pseudo-Bartter syndrome seem to be more dose-dependent than cortical hyperostosis.
Tálosi
Gyula
G
Department of Paediatrics, University of Szeged, Szeged, Hungary. talosigy@pedia.szote.u-szeged.hu
Katona
Márta
M
Túri
Sándor
S
D000136:Acid-Base Equilibrium; D000469:Alkaline Phosphatase / Q000097:blood; D000527:Alprostadil / Q000008:administration & dosage / Q000009:adverse effects*; D001477:Bartter Syndrome / Q000097:blood / Q000188:drug therapy*; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D005500:Follow-Up Studies; D017219:Gastric Outlet Obstruction / Q000097:blood / Q000188:drug therapy*; D006330:Heart Defects, Congenital / Q000097:blood / Q000188:drug therapy*; D006801:Humans; D006958:Hyperostosis, Cortical, Congenital / Q000097:blood / Q000188:drug therapy*; D007231:Infant, Newborn; D007262:Infusions, Intravenous; D007958:Leukocyte Count; D007964:Leukocytosis / Q000097:blood / Q000139:chemically induced*; D008297:Male; D011379:Prognosis; D012189:Retrospective Studies; D013997:Time Factors
D005343:Fibrinolytic Agents; D000469:Alkaline Phosphatase; D000527:Alprostadil