Human fetal malformations associated with the use of an angiotensin II receptor antagonist: Case Report

Korkes, Henri Augusto; Oliveira, Leandro De; Berlinck, Livia; Goes, Fernanda Sampaio; Borges, Antonio Fernando Allemand; Kirsztajn, Gianna Mastroianni; Sass, Nelson

doi:10.5935/0101-2800.20140059

Cited by 3 publications

(3 citation statements)

References 18 publications

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“… 2 , 6 , 15 – 17 According to the literature ( Table 1 ) , among 12 newborns exposed to ARA IIs during pregnancy and with neonatal hypocalvaria, 5 had neonatal anuria. 6 , 9 , 12 , 15 – 19 , 28 , 29 Of these, three died in the immediate postnatal period and the two survivors had chronic renal failure. In the absence of neonatal anuria, all newborns with hypocalvaria are alive (n = 6).…”

Section: Discussionmentioning

confidence: 99%

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Prenatal hypocalvaria after prolonged intrauterine exposure to angiotensin II receptor antagonists

Lallemant

Prevost

Nobili

et al. 2018

J Renin Angiotensin Aldosterone Syst

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We report a case of prenatal exposure to angiotensin II receptor antagonists (ARA II) from the beginning of pregnancy in a patient with a hypokinetic dilated cardiomyopathy. This case report emphasizes the fetal renal impact of prolonged intrauterine exposure to renin-angiotensin system (RAS) blockers, and highlights that this exposure can cause severe prenatal hypocalvaria. This delayed ossification can be reversible after birth, but the presence of anhydramnios indicates an early and irreversible block of RAS blockers in the fetus that is responsible for fetal kidney development abnormalities. This association carries a high risk of neonatal death. Prolonged exposure to ARA II or other RAS blockers remains prohibited throughout pregnancy.

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Section: Discussionmentioning

confidence: 99%

“…Regarding birth modalities, all newborns with prenatal hypocalvaria are born by caesarean section in order to limit the crushing forces applied to the skull during vaginal delivery. 2 , 6 , 8 , 9 , 12 , 15 – 17 , 28 …”

Section: Discussionmentioning

confidence: 99%

Prenatal hypocalvaria after prolonged intrauterine exposure to angiotensin II receptor antagonists

Lallemant

Prevost

Nobili

et al. 2018

J Renin Angiotensin Aldosterone Syst

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“…40–42 However ARBs are not good during pregnancy due to their well-documented association with birth defects. 43–46 Thus another therapeutic option to inhibit the actions of AT1-AAs directly is warranted. Recently, we have shown that AT1-AA inhibition by a specific modified peptide sequence which binds AT1-AAs and prevent them from binding to the AT1 receptor during pregnancy improved the PE symptoms associated with placental ischemic rats.…”

Section: At1-aa Future Directions and Therapymentioning

confidence: 99%

The Role of Agonistic Autoantibodies to the Angiotensin II Type 1 Receptor (AT1-AA) in Pathophysiology of Preeclampsia

Campbell

LaMarca

Cunningham

2018

CPB

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Preeclampsia is the leading cause of death and morbidity world-wide for the mother and fetus during pregnancy. Preeclampsia does not only effect the mother and the baby during pregnancy, but can also have long-term effects, such as the increase risk of hypertension and cardiovascular disease, on the offspring and the postpartum mother later in life. The exact cause of preeclampsia is unknown, but women with preeclampsia have elevated concentrations of agonistic autoantibodies against the angiotensin II type 1 receptor (AT1-AA). These AT1-AA’s through multiple studies have shown to play a significant role in the pathology and possible genesis of preeclampsia. This review will discuss the discovery of AT1-AAs and the role of AT1-AAs in the pathophysiology of preeclampsia. This review will also discuss future therapeutic approaches towards the AT1-AA to prevent adverse pregnancy outcomes. Furthermore, we will examine the relationship between AT1-AA induced hypertension associated with increase oxidative stress, antiangiogenic factors (such as soluble fms-related tyrosine kinase-1 (sFlt-1), endothelin-1 (ET-1), inflammation, endothelial dysfunction, and reduced renal function. Understanding the pathological role of AT1-AAs in hypertensive pregnancies is important as we search for novel therapies to manage preeclampsia.

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Development of the Renin-Angiotensin System

Smith¹

2017

Fetal and Neonatal Physiology

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Human fetal malformations associated with the use of an angiotensin II receptor antagonist: Case Report

Abstract: Human fetal malformations associated with the use of an angiotensin II receptor antagonist: Case ReportMalformações fetais associadas ao uso de antagonista dos receptores de angiotensina II: Relato de Caso

Cited by 3 publications

References 18 publications

Prenatal hypocalvaria after prolonged intrauterine exposure to angiotensin II receptor antagonists

Prenatal hypocalvaria after prolonged intrauterine exposure to angiotensin II receptor antagonists

The Role of Agonistic Autoantibodies to the Angiotensin II Type 1 Receptor (AT1-AA) in Pathophysiology of Preeclampsia

Development of the Renin-Angiotensin System

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