Reactions 1435 - 19 Jan 2013

Terlipressin

Increased troponin levels in a neonate: case reportA male baby, who was born at 40 weeks of gestational age,

developed increased troponin levels following treatment withterlipressin for refractory hypotension and oliguria.

The baby was delivered by an emergency caesarean sectiondue to perinatal asphyxia. He was resuscitated at birth, andechocardiogram showed both a tricuspid valve regurgitationand mild pulmonary hypertension. He underwent varioustreatments including therapeutic cooling. After rewarming wasstarted, he developed hypotension and a reduction in urineoutput. He did not respond to volume loads or furosemide. Hewas started on terlipressin 0.02 mg/kg every 6 hours [route notstated]. His BP increased, and his diuresis was re-established.Terlipressin was continued for 12 hours (three doses).

The baby improved clinically and was discharged. Of note,he had transient increases in his troponin, AST and ALT levelsfollowing terlipressin use [duration of treatment to reactiononset and age at reaction onset not clearly stated].

Author comment: "[Terlipressin] treatment was welltolerated; however, the simultaneous transient furtherincrease of troponin levels observed during [terlipressin]treatment confirms the potential risk of excessive coronaryvasoconstriction".Radicioni M, et al. Effects of terlipressin on pulmonary artery pressure in a septiccooled infant: An echocardiographic assessment. Journal of Perinatology 32:893-895, No. 11, Nov 2012. Available from: URL: http://dx.doi.org/10.1038/jp.2011.181 - Italy 803082301

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Reactions 19 Jan 2013 No. 14350114-9954/10/1435-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved