Abstract
BackgroundAlthough persistent pulmonary hypertension of the newborn (PPHN) and infantile hypertrophic pyloric stenosis (HPS) are both well-known diseases that occur in early infancy, PPHN complicated by HPS is rare. As nitric oxide (NO) is an important mediator of biological functions, on both the vascular endothelium and smooth muscle cells, the decreased production of NO might play a role in the pathogenesis of both PPHN and HPS. We present the case of a neonate who developed HPS following PPHN, including a detailed review on research published to date, and we discuss the pathogenesis of PPHN and HPS.Case presentationA female neonate born at 38 weeks of gestation, weighing 3140 g, developed PPHN due to meconium aspiration syndrome. Intensive treatment with high frequency oscillations and inhaled NO were initiated, and sildenafil and bosentan were added. She gradually recovered. At 15 days of age, the patient developed recurrent vomiting after feeding and the diagnosis of HPS was made. Intravenous atropine therapy was started at 20 days of age, but the efficacy was clinically unsatisfactory. The coadministration with transdermal nitroglycerin improved the symptoms, and oral feeding was successfully re-introduced.ConclusionsOur patient recovered from both PPHN and HPS using NO-related medications. A decrease in NO synthesis is likely to be a common pathway for PPHN and HPS.
Highlights
Persistent pulmonary hypertension of the newborn (PPHN) and infantile hypertrophic pyloric stenosis (HPS) are both well-known diseases that occur in early infancy, PPHN complicated by HPS is rare
Our patient recovered from both PPHN and HPS using nitric oxide (NO)-related medications
A decrease in NO synthesis is likely to be a common pathway for PPHN and HPS
Summary
The present patient recovered from both PPHN and HPS using NO-related medications. A decrease in NO synthesis is likely to be a common pathway for PPHN and HPS. If an infant recovering from PPHN develops recurrent vomiting, physicians should consider HPS as a complication. Availability of data and materials All data generated or analyzed during this study are included in this published article. Authors’ contributions SI wrote the first draft of the manuscript; DU, TB, and AO performed the clinical practice. All authors reviewed the manuscript for important intellectual content and approved the final version to be published. Ethics approval and consent to participate Our ethics committee waived the requirement of ethics approval because all medical and laboratory procedures are routinely carried out and do not affect decisions concerning treatment. Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations
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