Recurrent exacerbations of protein-losing enteropathy after initiation of growth hormone therapy in a Fontan patient controlled with spironolactone.

Abstract

Protein-losing enteropathy (PLE) is a rare, but serious complication in single ventricle patients after Fontan palliation, and is associated with a 5-year mortality of 46%. We describe a patient with PLE after Fontan palliation who achieved remission with high-dose spironolactone (an aldosterone antagonist), but had three exacerbations each temporally correlated with the use of growth hormone (an aldosterone agonist). Because of the opposing mechanisms of action of these two medications, caution might be indicated when using growth hormone for patients with PLE who are successfully treated with spironolactone.

• Authors: Michael J Grattan, Brian W McCrindle
• Journal: Congenital heart disease (Congenit Heart Dis) 2010 Mar-Apr Vol. 5 Issue 2 Pg. 165-7 ISSN: 1747-0803 [Electronic] United States
• PMID: 20412490 (Publication Type: Case Reports, Journal Article)

Chemical References

• Mineralocorticoid Receptor Antagonists
• Human Growth Hormone
• Spironolactone
• Aldosterone

Topics

• Adolescent
• Aldosterone (agonists)
• Fontan Procedure (adverse effects)
• Growth Disorders (complications, drug therapy)
• Heart Defects, Congenital (complications, surgery)
• Human Growth Hormone (adverse effects, therapeutic use)
• Humans
• Male
• Mineralocorticoid Receptor Antagonists (therapeutic use)
• Palliative Care
• Protein-Losing Enteropathies (drug therapy, etiology, physiopathology)
• Recurrence
• Remission Induction
• Spironolactone (therapeutic use)