Successful mechanical circulatory support for 251 days in a child with intermittent severe neutropenia due to Barth syndrome.

Abstract

Barth syndrome is an X-linked recessive disorder that is characterized by cardiomyopathy, variable neutropenia, skeletal myopathy, growth delay, and organic aciduria. The cardiac involvement typically results in a high risk of severe heart failure in infancy or early childhood. While Berlin Heart EXCOR is widely accepted as ventricular assistance in pediatric patients with end-stage cardiac failure, infections remain a frequent and potentially severe complication. Therefore, the extended use of the device in the setting of intermittent or severe neutropenia is challenging. We present the case of a three-yr child with Barth syndrome who was bridged successfully to transplant with a Berlin Heart EXCOR assist device for eight months (251 days) without major infectious complication, despite several episodes of severe neutropenia. This case demonstrates that prolonged mechanical circulatory support for a patient with neutropenia is feasible without important morbidity, with careful monitoring and a multidisciplinary approach. G-CSF provides an excellent support in managing neutropenia.

• Authors: Nathalie Dedieu, Alessandro Giardini, Colin G Steward, Matthew Fenton, Ann Karimova, T Y Hsia, Michael Burch
• Journal: Pediatric transplantation (Pediatr Transplant) Vol. 17 Issue 2 Pg. E46-9 (Mar 2013) ISSN: 1399-3046 [Electronic] Denmark
• PMID: 23190323 (Publication Type: Case Reports, Journal Article)
• Copyright: © 2012 John Wiley & Sons A/S.

Topics

• Barth Syndrome (complications, surgery)
• Child, Preschool
• Heart-Assist Devices
• Humans
• Male
• Neutropenia (etiology)