Dysmorphic child born after maternal diclofenac therapy.

摘要

A five-month-old baby was brought with complaints of abnormal facial features. A detailed birth and past history revealed that the baby was the third child, born of a non-consanguineous marriage. The mother was prescribed tablet diclofenac sodium (100 mg thrice daily) by a general practitioner for joint pain during the first trimester of pregnancy. The joint pain disappeared after four days. However, she continued taking tablet diclofenac on her own. There was no significant antenatal history suggestive of systemic disease. She delivered a full-term baby boy, with a birth weight of 2.25 kg, and was discharged on breast feeds on the second postnatal day. After three months an echocardiography was done in view of recurrent lower respiratory tract infections. It showed a 4.5 mm non-restrictive patent ductus arteriosus (left to right), 4 mm atrial septal defect (left to right), and severe pulmonary artery hypertension. On examination, the head circumference was 41 cm., weight was 3.1 kg, and length was 58 cm (below the fifth percentile for age and gender), suggestive of failure to thrive. Dysmorphic facies were present in the form of low set and deformed external ears. Oral cavity examination revealed a high arched palate. He also had hypertelorism and wide spaced nipples [Figure 1 ]. Serologic tests for toxoplasma, rubella, cytomegalovirus, and herpes simplex were negative.