Document Detail


Angiotensin II receptor blocker induced fetopathy: 7 cases.
MedLine Citation:
PMID:  21271514     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: During a period of 12 months 7 newborns with a partially severe fetopathy caused most probably by maternal sartan-intake in pregnancy were treated in 5 German teaching hospitals. Sartans antagonize the effect of angiotensin II at the AT1-receptor and are used to treat arterial hypertension.
METHOD: We presented 2 cases at the yearly GNPI meeting 2010 and we were informed about similar cases in other German teaching hospitals which we brought together in this publication.
RESULTS: In the presented cases, maternal sartan intake was noticed at different times in pregnancy and was in part discontinued some weeks before delivery. In all pregnancies oligohydramnios was present and fetal kidneys displayed a hyperechogenic structure on ultrasound. The newborns' postnatal course varied: oligohydramnios sequence with lung hypoplasia, arterial hypotension and renal insufficiency were the predominant problems of the first days of life. The majority (4/7) of infants did not survive this period, in other cases there was a complete (1/7) recovery of renal function whereas others survived with renal impairment (2/7), in part requiring chronic dialysis. Further distinctive features seen frequently were disturbances of cranial ossification and flaccid paralysis of hands and feet with deviations as well as sensorineural hearing loss.
CONCLUSION: These case reports again underline the hazardousness of maternal sartan intake with potential fatal outcome for the newborn. Though the use of sartans in pregnancy is contraindicated and several case reports of sartan induced fetopathies exist, the risk of sartan treatment generally seems to be underestimated.
Authors:
C Hünseler; A Paneitz; D Friedrich; U Lindner; A Oberthuer; F Körber; K Schmitt; L Welzing; A Müller; P Herkenrath; B Hoppe; L Gortner; B Roth; E Kattner; T Schaible
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Publication Detail:
Type:  Journal Article     Date:  2011-01-26
Journal Detail:
Title:  Klinische Pädiatrie     Volume:  223     ISSN:  1439-3824     ISO Abbreviation:  Klin Padiatr     Publication Date:  2011 Jan 
Date Detail:
Created Date:  2011-01-28     Completed Date:  2011-06-24     Revised Date:  2013-05-28    
Medline Journal Info:
Nlm Unique ID:  0326144     Medline TA:  Klin Padiatr     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  10-4     Citation Subset:  IM    
Copyright Information:
© Georg Thieme Verlag KG Stuttgart · New York.
Affiliation:
Neonatology, Children's Hospital, University of Cologne, Germany. christoph.huenseler@uni-koeln.de
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MeSH Terms
Descriptor/Qualifier:
Abnormalities, Drug-Induced / diagnosis,  etiology*,  pathology
Adult
Angiotensin II Type 1 Receptor Blockers / therapeutic use,  toxicity*
Antihypertensive Agents / therapeutic use,  toxicity*
Apgar Score
Benzimidazoles / therapeutic use,  toxicity
Female
Fetal Growth Retardation / chemically induced,  diagnosis,  pathology
Humans
Hypertension, Pregnancy-Induced / drug therapy*
Hypertension, Pulmonary / chemically induced,  diagnosis,  pathology
Imidazoles / therapeutic use,  toxicity
Infant, Newborn
Kidney / abnormalities,  drug effects,  pathology
Lung / abnormalities,  drug effects,  pathology
Male
Oligohydramnios / chemically induced
Pregnancy
Pregnancy Trimester, Second
Pregnancy Trimester, Third
Renal Insufficiency / chemically induced,  diagnosis,  pathology
Skull / abnormalities,  drug effects,  pathology
Tetrazoles / therapeutic use,  toxicity
Ultrasonography, Prenatal
Valine / analogs & derivatives,  therapeutic use,  toxicity
Chemical
Reg. No./Substance:
0/Angiotensin II Type 1 Receptor Blockers; 0/Antihypertensive Agents; 0/Benzimidazoles; 0/Imidazoles; 0/Tetrazoles; 137862-53-4/valsartan; 7004-03-7/Valine; 8W1IQP3U10/olmesartan; S8Q36MD2XX/candesartan
Comments/Corrections
Comment In:
Klin Padiatr. 2011 Jan;223(1):4   [PMID:  21271512 ]

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