Resolution of cor pulmonale after medical management in a patient with cblC-type methylmalonic aciduria and homocystinuria: a case report.
We describe a 3-year-old Hispanic male with cblC-type methylmalonic aciduria and homocystinuria who presented to the emergency department with progressive tachypnea, vomiting, and edema secondary to pulmonary embolism and cor pulmonale. With aggressive medical management, there was complete resolution of right heart failure and pulmonary hypertension after 3 months. Pulmonary embolism is rare in the pediatric population. Children with cblC-type methylmalonic aciduria and homocystinuria may be at increased risk for thrombus formation and pulmonary embolism due to chronic hyperhomocystinemia, a risk factor for thrombus formation in the adult population. Aspirin therapy may be indicated in children with inborn errors of metabolism that predispose to hyperhomocystinemia.
Profitlich
Laurie
L
1Department of Pediatrics, Division of Pediatric Cardiology, Mount Sinai School of Medicine, 1 Gustave L. Levy Place, Box 1201, New York, New York 10029, USA. laurie.profitlich@mssm.edu
Kirmse
Brian
B
Wasserstein
Melissa P
MP
Diaz
George
G
Srivastava
Shubhika
S