CATECHOLAMINE EXCESS IN THE NEWBORN: A NEW SYNDROME
| Autor: | Leila Mei Pang, Joel S. Lipset, Robert B. Mellins, S. Alex Stalcup, William A. Blanc, John M. Driscoll |
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| Rok vydání: | 1977 |
| Předmět: | |
| Zdroj: | Pediatric Research. 11:432-432 |
| ISSN: | 1530-0447 0031-3998 |
| DOI: | 10.1203/00006450-197704000-00375 |
| Popis: | We measured strikingly increased urinary and serum levels of catecholamines in a newborn with gangrene of the extremities, hypertension (BP 200/160), myocarditis, enterocolitis, hematologic abnormalities (thrombocytopenia, hyperkininemia with edema, disseminated intravascular coagulation) renal disease (proteinuria, oliguria), seizures and coma. Total serum catechols were 6.0 ng/ml (normal 0.2-0.5 ng/ml). Urine catechol levels in ug/mg creatinine were determined before and after 12 hrs. of therapy with α-methyl-paratyrosine (α-MPT), an inhibitor of endogenous catechol synthesis. Phentolamine test was positive; treatment with peripheral alpha-blockade normalized blood pressure. During one month of α-MPT therapy, all chemical and physical abnormalities were largely reversed. Two attempts to taper α-MPT were followed by hypertension. Following death attributable to sepsis and DIC, extensive autopsy failed to reveal a catechol source. Because catechol excess is a potentially treatable cause of this catastrophic circulatory disorder, it should be considered in the differential diagnosis of hypertension and of peripheral gangrene in infants. |
| Databáze: | OpenAIRE |
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