The Turkish Journal of Pediatrics
2013 , Vol 55 , Num 5
Generalized periosteal reaction and tissue swelling secondary to prolonged prostaglandin E1 infusion and venous stasis: a case report
Divisions of 1Neonatology and 2Pediatric Cardiology, Department of Pediatrics, Ankara University Faculty of Medicine,
Ankara, Turkey. E-mail: alanserdar@gmail.com
Prostaglandin E1 (PGE1) is the drug of choice for providing ductal patency
in cyanotic congenital heart disease (CCHD) for a short period of time
until essential surgical management. Occasionally, prolonged use of PGE1
is required when the surgical procedure is delayed due to certain clinical
conditions. Prolonged use of PGE1 may lead to bone and tissue changes such
as pretibial and soft tissue swelling of the extremities and reversible cortical
proliferation of the bones. Venous stasis as an additional risk factor can result
in generalized periosteal reaction that initially can cause the separation of the
periosteum from the cortex. We report an infant with CCHD who developed
severe tissue swelling and generalized periosteal reaction due to coexistence
of prolonged use of PGE1 and venous stasis. To the best of our knowledge,
this is the first case report with both of these risk factors.
Keywords :
cyanotic congenital heart disease, newborn, periosteal reaction, prostaglandin
E1, venous stasis.