caa a22 4500 445824956 CHVBK 20180317145256.0 cr unu---uuuuu 170323e20110401xx s 000 0 eng 10.1007/s00246-011-9913-z doi (NATIONALLICENCE)springer-10.1007/s00246-011-9913-z Congenital Cardiac Defects: A Possible Association of Aminopterin Syndrome and In Utero Methotrexate Exposure? [Elektronische Daten] [Kurt Piggott, Andrea Sorbello, Elise Riddle, William DeCampli] Folate antagonist are chemotherapeutic agents used in many neoplastic, autoimmune, and inflammatory disorders. The first suggestions that folic acid antagonists were teratogenic in humans were based on reports of failed terminations in mothers given aminopterin in the first trimester. Newborns who survived after aminopterin exposure were noted for years to have defects of the neural tube, skull, or limbs. There is now a well-defined syndrome of congenital anomalies associated with the use of aminopterin. The aminopterin syndrome consists of cranial dystosis, hypertelorism, anomalies of the external ears, micrognathia, limb anomalies, and cleft palate. The use of aminopterin has now fallen out of favor. Methotrexate is a folate antagonist that is now used more frequently. A similar pattern of malformations has been found in fetuses exposed to methotrexate. If used during pregnancy, it can cause congenital malformations or fetal death. A consistent association between methotrexate exposure and cardiac, renal, or gastrointestinal malformations has not been reported. We report two patients who presented with classic features of aminopterin syndrome combined with significant congenital cardiac malformations after first-trimester in utero methotrexate exposure. Both of these patients survived to undergo corrective cardiac surgery. Springer Science+Business Media, LLC, 2011 Methotrexate nationallicence Aminopterin syndrome nationallicence Congenital heart disease nationallicence Piggott Kurt Congenital Heart Institute, Arnold Palmer Hospital for Children, 50 W. Sturtevant St., 32806, Orlando, FL, USA aut Sorbello Andrea Congenital Heart Institute, Arnold Palmer Hospital for Children, 50 W. Sturtevant St., 32806, Orlando, FL, USA aut Riddle Elise Congenital Heart Institute, Arnold Palmer Hospital for Children, 50 W. Sturtevant St., 32806, Orlando, FL, USA aut DeCampli William Congenital Heart Institute, Arnold Palmer Hospital for Children, 50 W. Sturtevant St., 32806, Orlando, FL, USA aut Pediatric Cardiology Springer-Verlag 32/4(2011-04-01), 518-520 0172-0643 32:4<518 2011 32 246 https://doi.org/10.1007/s00246-011-9913-z text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s00246-011-9913-z text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Piggott Kurt Congenital Heart Institute, Arnold Palmer Hospital for Children, 50 W. Sturtevant St., 32806, Orlando, FL, USA aut NATIONALLICENCE 700 1- Sorbello Andrea Congenital Heart Institute, Arnold Palmer Hospital for Children, 50 W. Sturtevant St., 32806, Orlando, FL, USA aut NATIONALLICENCE 700 1- Riddle Elise Congenital Heart Institute, Arnold Palmer Hospital for Children, 50 W. Sturtevant St., 32806, Orlando, FL, USA aut NATIONALLICENCE 700 1- DeCampli William Congenital Heart Institute, Arnold Palmer Hospital for Children, 50 W. Sturtevant St., 32806, Orlando, FL, USA aut NATIONALLICENCE 773 0- Pediatric Cardiology Springer-Verlag 32/4(2011-04-01), 518-520 0172-0643 32:4<518 2011 32 246 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer