Corticotropin

Abstract

Lipomatous atrial septal hypertrophy: case report A male infant [age at event onset not stated] developed lipomatous atrial septal hypertrophy during treatment with corticotropin for infantile spasms. The infant was diagnosed with Down syndrome and secondary West syndrome at the age of 9 months. He required gradual uptitration of corticotropin [adrenocorticotropin] hormone (maximum 0.5 mg/day) for infantile spasms [initial dosage not stated; route not stated]. From a cardiological viewpoint, he was asymptomatic, but he had obesity, buffalo hump, high blood pressure and moon face secondary to the Cushing syndrome. An electrocardiogram was unremarkable, but echocardiography showed a large hyperechogenic non-obstructive mass at the inter-atrial septum and left ventricular non-obstructive hypertrophic cardiomyopathy. Therefore, differential diagnosis of infective endocarditis, cardiac thrombus and cardiac tumours were made. However, these diagnoses were ruled out initially. The ‘dumbbell-shaped’ morphology was suggestive of lipomatous atrial septum hypertrophy. The lipomatous atrial septum hypertrophy was considered to be related to corticotropin [duration of treatment to reaction onset not stated]. Therefore, the infant’s corticotropin was discontinued. Consequently, the cardiac complication resolved, and Cushing’s syndrome regressed. At the age of 2 years, the echocardiographic findings disappeared completely.