Complex therapeutic approach in a child with syndromic morbid obesity and acute heart failure.docVIP

HVM BIOFLUX Human Veterinary Medicine International Journal of the Bioflux Society Complex therapeutic approach in a child with syndromic morbid obesity and acute heart failure 1 Lenu?a Popa, ?tefan H. Ro?ianu, Eva Kiss, Carmencita L. Dene?, 2 1 3 3 1 Octavia Costin, and Virgil Popa 1 Pediatrics Clinic I, “Iuliu Ha?ieganu” University of Medicine and Pharmacy, Cluj–Napoca, 2 Cluj, Romania; Department of Cardiology, Heart Institute “Niculae Stancioiu”, “Iuliu 3 Ha?ieganu” University of Medicine and Pharmacy, Cluj–Napoca, Cluj, Romania; Radiology and Central Laboratory, Clinic Emergency Hospital for Children, Cluj-Napoca, Cluj, Romania. Corresponding author: L. Popa, lpopa12@ Abstract. We report a case of a three years old child, a boy with acute heart failure associated at a rare complex genetic disorders characterized by severe obesity and hypotonia. The treatment consisted of acute phase diuretics and cardiotonic drugs, followed by chronic angiotensin-converting-enzyme (ACE) inhibitor (Enalapril) and an aldosterone inhibitor. The child recovered within a few days and remained clinically stable, with improvement of clinical, EKG and echocardiographic parameters at 2 and 6 - month follow-up. Key words: child, severe obesity, acute heart failure, ACE-inhibitors. Introduction. Prader-Willi syndrome (PWS) is a complex multisystem rare genetic disorder, with population prevalence at about 1 in 50,000, and it is the most frequent cause of syndromic obesity. A variety of phenotype features including severe neonatal hypotonia, hyperphagia and childhood-onset morbid obesity, short stature, hypothalamic hypogonadism, dysmorphic features, developmental delay, learning difficulties, behavioral and psychiatric problems characterize this syndrome. The affected persons have high rates and vari