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Findings that shed new light on the possible pathogenesis of a disease or an adverse effect
CASE REPORT
Maternal olmesartan exposure causing neonatal failure
  1. Antonio Pérez-Iranzo1,2,
  2. Ana Nos Ferreres3,
  3. Aranzazu Jarque Bou4
  1. 1 NICU, Hospital General de Castellón, Castellón, Spain
  2. 2 Cardiac Intensive Care Unit, Great Ormond Street Hospital For Children NHS Trust, London, UK
  3. 3 NICU, Hospital General de Castellon, Castellon de la Plana, Spain
  4. 4 Department of NICU, Hospital General de Castellon, Castellon de la Plana, Spain
  1. Correspondence to Dr Antonio Pérez-Iranzo, Antonio.Perez-Iranzo{at}gosh.nhs.uk

Summary

Although angiotensin II receptor blockers (ARBs) are contraindicated during pregnancy, new cases are currently being reported.

A 32-week preterm neonate was admitted after C-section due to maternal oligohydramnios. He presented with Potter phenotype, pulmonary hypoplasia with pneumothorax, systemic hypotension and anuria. He required chest drain insertion and continuous positive airway pressure (CPAP), volume expansion plus inotropic support with persistent renal failure. Mother confirmed olmesartan intake during entire pregnancy. Peritoneal dialysis was started with improvement in renal markers and progressive recovery of renal function. He has been followed up until the age of 2 years, observing improved renal function with a glomerular filtration rate (GFR) of 58 mL/min/1.72 m2.

Both angiogenesis-converting enzyme inhibitor and ARBs affect nephrogenesis; ARBs being more harmful due to its higher activity. Although some patients may recover normal renal function, its teratogen effect may have fatal consequences. Thus, it is important to emphasise its harmful effects in neonates to avoid new cases.

  • neonatal intensive care
  • materno-fetal medicine
  • neonatal health
  • preventative pediatrics
  • unwanted effects / adverse reactions

https://doi.org/10.1136/bcr-2016-218921

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    Footnotes

    • Handling editor Seema Biswas

    • Contributors ANF and AJB have contributed in this article through planning, obtaining consent from father, acquisition of data and partial writing of the present report. AP-I has directed and supervised them in actively translating and writing the final article.

    • Competing interests None declared.

    • Patient consent Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.