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Annals of Clinical Case Reports
2017 | Volume 2 | Article 1284 1
Introduction
Colchicine treatment improved female fertility and the outcome of pregnancy in Familial
Mediterranean Fever patients by preventing the serosal adhesions and controlling the acute attacks.
Familial Mediterranean Fever (FMF) is a hereditary autoinfammatory disorder, characterized
by acute attacks of fever and serosal infammation which is more frequent in Jewish, Armenian,
Turkish and Arabic populations [1]. Untreated or inadequately treated patients have the risk of
amyloidosis, which is an important cause of morbidity and mortality. Colchicine has been used in
the treatment of FMF since the 1970s and remains unrivalled in this respect [2].
It is necessary to control FMF attacks during pregnancy, because peritonitis may lead to early
contractions of the uterus and eventual abortions [3]. However, colchicine treatment improved
female fertility and the outcome of pregnancy by preventing the serosal adhesions and controlling
the acute attacks. Limited number of human series does not show any proof for increased abortus,
stillbirth, or teratogenic efect of colchicine. Terefore, the present opinion is that female patients
with FMF should continue taking the optimal dose of colchicine during their pregnancy and that
there is no need for amniocentesis during pregnancy [1,4]. Here we present a term newborn with
pulmonary atresia that may be a teratogenic efect of antenatal colchicine exposure.
Case Presentation
A 4110 gram, male infant with gestational age of 38 weeks, was delivered via cesarean section
from 31-year-old primiparous mother with FMF. Te mother was on 1.5 mg/day colchicine
treatment. Te infant’s Apgar scores were 9 and 10. Infant was in normal appearance and acyanotic.
His pulse oximetry oxygen saturation levels were around 90% at preductal and 88% at postductal
sites. A systolic ejection murmur was heard. He was admitted to neonatal intensive care unit due
to antenatal diagnosis of pulmonary stenosis (PS) on fetal echocardiography performed at 24th
gestational week. Postnatal echocardiography revealed pulmonary atresia (PA) with no fow at
pulmonary valve, right ventricle was hypertrophic with a second-degree tricuspid insufciency
(Figure 1). Pulmonary artery was flled via ductus arteriosus with a lef to right shunt. Lef ventricle
and lef atrium size were normal.Immediate prostaglandin infusion was initiated and urgent thorax
computed tomography angiogram confrmed an atretic pulmonary valve and anatrial septal defect
(Figure 2).
Te initial complete blood count, biochemistry and acute phase reactant studies were normal.
A Newborn with Pulmonary Atresia and Antenatal
Colchicine Exposure
OPEN ACCESS
*Correspondence:
Nilgün Kültürsay, Ege University
Children Hospital, Head and Division
of Neonatology, 35100, Bornova, İzmir,
Turkey, Tel: +90 5326082890;
E-mail: nilgunkultursay@gmail.com
Received Date: 02 Jan 2017
Accepted Date: 27 Feb 2017
Published Date: 01 Mar 2017
Citation:
Ergin F, Terek D, Yalaz M, Levent E,
Köroğlu ÖA, Göksel S, et al. A Newborn
with Pulmonary Atresia and Antenatal
Colchicine Exposure. Ann Clin Case
Rep. 2017; 2: 1284.
Copyright © 2017 Kültürsay N. This is
an open access article distributed under
the Creative Commons Attribution
License, which permits unrestricted
use, distribution, and reproduction in
any medium, provided the original work
is properly cited.
Case Report
Published: 01 Mar, 2017
Abstract
Colchicine treatment improved female fertility and the outcome of pregnancy in Familial
Mediterranean Fever patients by preventing the serosal adhesions and controlling the acute attacks.
Limited number of human series does not show any proof for increased abortus, stillbirth or
teratogenic efect of colchicine. Here we present a term newborn with pulmonary atresia whose
mother was on colchicine during pregnancy. Tese two events may be coincidentally related;
however, there may be a causal relationship that has not been reported in the literature yet. Fetal
echocardiography is strongly recommended for women who are pregnant and taking colchicine.
Keywords: Colchicine; Teratogen; Newborn; Heart defect; Pulmonary atresia
Fırat Ergin
1
, Demet Terek
1
, Mehmet Yalaz
1
, Ertürk Levent
2
, Özge Altun Köroğlu
1
, Sibel Göksel
3
,
Mete Akısü
1
, Ferda Özkınay
4
and Nilgün Kültürsay
1
*
1
Department of Pediatrics, Division of Neonatology, Ege University, Turkey
2
Department of Pediatrics, Division of Cardiology, Ege University, Turkey
3
Department of Pharmacology, Ege University, Turkey
4
Department of Pediatrics, Division of Genetics, Ege University, Turkey