title: Developmental delay associated with normal thyroidal function and long-term amiodarone therapy during fetal and neonatal life.
abstract: We reported a case of a child with neurodevelopment delay induced by long-term amiodarone exposure due to a treatment of fetal supraventricular tachycardia (FSVT), subtype permanent junctional reciprocating tachycardia (PJRT) with the normal thyroidal function. Refractory persistent FSVT was treated intrautero with digoxin (0.5 mg QD) until delivery and amiodarone (100 mg QD) from 26 to 35 weeks of gestation. A baby weighing 3550 g with normal acid-base status was delivered at 38 weeks of gestation. The PJRT recurred 28 hours after delivery and reverted to sinus rhythm with amiodarone and propranolol for another 24 months. The neurological disturbances were manifested at the age of 12 months, when hypotonia and delayed motor milestones were recognised. At the age of 18 months, the child had mildly neurological development delay with hypotonia, ataxia and foot deformities. At the age of 24 months, motor milestones were mildly delayed with the usage of a few words without the ability to connect them into the sentence. The developmental quotient (DQ) was 68. Electroencephalogram and magnetic resonance imaging of the central nervous system were all normal. At the age of 30 months, motor milestones were still delayed together with speech development and language delay, only some words were used, not distinctly, DQ was 78. Thyroid function was normal on each examination. All blood and urine analyses were in normal ranges. Chromosome analysis did not show any abnormalities. Since we excluded all possible reasons, we could only bring an indirect link between the long-term amiodarone exposure during fetal and postnatal life and neurodevelopment delay.
authors.affiliation: Gyn/obs Clinic Narodni Front, Kraljice Natalije 62, School of Medicine, University of Belgrade, Belgrade, Serbia.
authors.forename: Zeljko
authors.initials: Z
authors.lastname: Mikovic
authors.forename: Natasa
authors.initials: N
authors.lastname: Karadzov
authors.forename: Ida
authors.initials: I
authors.lastname: Jovanovic
authors.forename: Vedrana
authors.initials: V
authors.lastname: Milic
authors.forename: Branislav
authors.initials: B
authors.lastname: Tomovic
authors.forename: Amira
authors.initials: A
authors.lastname: Egic
authors.forename: Gordana
authors.initials: G
authors.lastname: Dragovic Lukic
mesh_terms: D000638:Amiodarone / Q000009:adverse effects*; D000889:Anti-Arrhythmia Agents / Q000009:adverse effects*; D002657:Child Development / Q000187:drug effects*; D002675:Child, Preschool; D005260:Female; D005315:Fetal Diseases / Q000188:drug therapy*; D006801:Humans; D007231:Infant, Newborn; D011247:Pregnancy; D013617:Tachycardia, Supraventricular / Q000188:drug therapy*; D013961:Thyroid Gland / Q000187:drug effects* / Q000502:physiology
chemical_list: D000889:Anti-Arrhythmia Agents; D000638:Amiodarone