Resolution of calcific brown fat necrosis associated with prostaglandin therapy for cyanotic congenital heart disease in neonates: Report of two cases
Department of Diagnostic Imaging, The Hospital for Sick Children, 555 University Ave, Toronto, ON, Canada M5G 1X8.Pediatric Radiology (Impact Factor: 1.57). 12/2004; 34(11):919-23. DOI: 10.1007/s00247-004-1231-7
Prostaglandin E1 (PGE1) administration for palliation of cyanotic congenital heart disease in neonates has been associated with radiographically visible necrosis of brown fat about the neck and shoulder girdles. However, the natural history of this process has not been described. We present two patients with cyanotic congenital heart disease, treated preoperatively with prostaglandin E2 (PGE2), both of whom developed dramatic calcific brown fat necrosis. This process slowly resolved over time in both patients.
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ABSTRACT: First observed by two gynecologists, Kurzrok and Lieb, a substance found in semen was named prostaglandin by VonEuler of the Karolinska Institute, with the assumption that it was produced by the prostate gland (Clin Perinatol. 1995;22:457–477). Endogenous prostaglandins PGE2 and prostaglandin I2 are produced within the ductus arteriosus lumen during gestation to keep the ductus patent (Semin Perinatol. 1987;11:64–71). Practitioners can prolong the patency of the ductus arteriosus in neonates with ductal-dependent congenital heart defects through the use of injectable prostaglandin. In 1981, the Food and Drug Administration approved Alprostadil, injectable prostaglandin E1, for use in the treatment of neonates with congenital heart disease (Drug Intell Clin Pharm. 1982;16:823–832). This article will review the role of prostaglandin in intrauterine and extrauterine life, as well as the pharmacology, adverse effects, drug interactions, and nursing implications associated with prostaglandin E1 use.Newborn and Infant Nursing Reviews 09/2006; 6(3):158-162. DOI:10.1053/j.nainr.2006.05.001
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ABSTRACT: While reviewing chest CT scans of infants, we repeatedly observed hyperdense enhancing tissue in the chest wall that is not well described in radiology literature. This study was undertaken to describe the imaging features of this tissue in chest walls of infants. CT scans of the chest conducted on all infants between April 2008 and October 2009 were retrospectively reviewed. CT studies with any deviation from normal radiation or contrast dose or those with chest wall anatomical distortion were excluded. One hundred eighty-eight infants were scanned, with 202 MDCTs, of which 180 (89.1%) received contrast agent. Fifty-four of 180 (30%) cases revealed focal areas of hyperdensity in various locations. All positive cases ranged between 2 days and 9 months of age. The areas of distribution of hyperdensity had excellent correlation with known areas of brown fat in the chest wall, known from nuclear medicine studies, and hence we concluded these to represent the same. Brown fat in the chest wall can be seen as enhancing tissue on contrast CT scans done on infants. This is a normal morphological component with the brown fat converting to normal fat. It is important to recognize it in the chest wall of infants to avoid misinterpretation.Pediatric Radiology 06/2011; 41(8):1020-7. DOI:10.1007/s00247-011-2085-4 · 1.57 Impact Factor
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