Case Report
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Oct 26, 2023; 11(30): 7440-7449
Published online Oct 26, 2023. doi: 10.12998/wjcc.v11.i30.7440
Pharmacogenomics-based individualized treatment of hypertension in preterm infants: A case report and review of the literature
Lian-Fang Tang, Ao Xu, Kai Liu
Lian-Fang Tang, Ao Xu, Department of Pediatrics, The First People’s Hospital of Yunnan Province, Kunming 650000, Yunnan Province, China
Kai Liu, Pulmonary and Critical Care Medicine, Kunming Children’s Hospital, Kunming 650000, Yunnan Province, China
Co-first authors: Lian-Fang Tang and Ao Xu.
Author contributions: Tang LF and Xu A contributed equally to this work; Tang LF and Xu A designed the research study; Liu K analyzed the data and wrote the manuscript; All authors have read and approve the final manuscript.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Kai Liu, PhD, Doctor, Pulmonary and Critical Care Medicine, Kunming Children’s Hospital, No. 28 Shulin Street, Kunming 650000, Yunnan Province, China. ynkmlk@foxmail.com
Received: August 1, 2023
Peer-review started: August 1, 2023
First decision: September 13, 2023
Revised: September 19, 2023
Accepted: September 27, 2023
Article in press: September 27, 2023
Published online: October 26, 2023
Processing time: 84 Days and 18.2 Hours
Abstract
BACKGROUND

Neonatal hypertension is a rare but potentially serious condition that requires careful monitoring and treatment. Pharmacogenomics can help guide individualized drug therapy and improve outcomes.

CASE SUMMARY

We report a case of a preterm infant with multiple complications, including bronchopulmonary dysplasia (BPD), sepsis, intracranial hemorrhage, and hypertension. The infant was treated with various drugs, including dexamethasone and amlodipine. The infant was diagnosed with neonatal hypertension based on blood pressure measurements exceeding the 95th percentile for his age and sex. The possible causes of hypertension included dexamethasone, hydrochlorothiazide, spironolactone, and BPD. The infant was treated with oral amlodipine to lower his blood pressure. A pharmacogenomic test was performed to evaluate the genetic polymorphisms of ABCB1 and CYP3A5, which are involved in the metabolism and transport of dexamethasone and amlodipine. The infant’s blood pressure was well controlled after the dose of amlodipine was reduced according to the pharmacogenomic results. The infant had a stable general condition and was discharged on the 100th d after birth.

CONCLUSION

This case illustrates the importance of regular blood pressure monitoring and etiological investigation in preterm infants with hypertension. Pharmacogenomics can provide useful information for individualized drug therapy and safety in this population.

Keywords: Pharmacogenomics; Hypertension; Preterm; Infants; Case report

Core Tip: This study presents a case report of a premature infant with hypertension and reviews the literature on pharmacogenomics-based individualized treatment. The findings suggest that pharmacogenomics can be used to personalize treatment for hypertension in preterm infants.