Oğuz Alev KUTLU, Fatih AKBIYIK, Sami ERBAY, SEMRA ÇETİNKAYA

Gebeliğinde sitalopram kullanan annenin bebeğinde gözlenen klitoral priapizm: İlaç etkisi mi, idiopatik mi?

Priapizm, penisin uzun süreli ve genellikle ağrılı ereksiyonu olarak tanımlanır ve yayınlanan tüm yeni doğan priapizm olguları erkek bebeklerdir. Literatürde kız bebekte yeni doğan klitoral priapizmi yoktur. Bir günlük kız hasta klitoromegali nedeniyle muayene edildi. Klitoris erekte, sert idi ve 16.4 mm olarak ölçüldü. Öyküde annenin hamileliği döneminde düzensiz olarak sitalopram kulllandığı öğrenildi. Doğumdan 48 saat sonraki kontrolde klitori- sin yumuşak ve küçüldüğü görüldü, 6.4 mm olarak ölçüldü. Neonatal klitoral priapizm, özellikle doğumdan hemen önce annenin düzensiz kullandığı citalopram nedeniyle olabilir.

Priapism observed in a baby whose mother used citalopram during pregnancy: idiopathic or the effect of maternal medication?

All of the newborn cases reported with priapism which is defined as the long duration and mostly painful erection of penis are males and there is no report about neonatal clitoral priapism by the date. A female newborn whose clitoris was hard and erected and measured as 16,4 mm. on the first day of her life is presented. Irregular citalopram usage during the pregnancy was reported in maternal history. The genital examination in the 48th hour revealed that the clitoris had got smaller and softer with a length of 6,4 mm. Clitoral priapism might resulted from irregular and/or high dose citalopram usage especially during the last days prior to birth.

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1. Imamoglu A, Bakirtas H, Conkbayir I, Tuygun C, Sarici H. An alternative noninvasive approach for the treatment of high-flow priapism in a child: Duplex ultrasound-guided compression. J Pediatr Surg 2006; 41:446-448.
2. Weatherall MW, Higgs DR, Weiss H, Weatherall DJ, Serjeant GR. Phenotype/genotype relationships in sickle cell disease: a pilot twin study. Clin Lab Haematol 2005; 27: 384- 390.
3. Pitetti RD, Nangia A, Bhende MS. Idiopathic priapism. Pediatr Emerg Care 1999; 15:404-406.
4. Cherian J, Rao AR, Thwaini A, Kapasi F, Shergill IS, Saman R. Medical and surgical management of priapism. Postgrad Med J 2006; 82:89-94.
5. Carillo AA, Damian M, Berkovitz G. Disorders of sexual differentiation. F Lifshitz (Ed.), Pediatric Endocrinology, New York, Informa Health Care, 2007, p.365-386.
6. Mentzel HJ, Kentouche K, Doerfel C, Vogt S, Zintl F, Kaiser WA. High-flow priapism in acute lymphatic leukaemia. Pediatr Radiol 2004; 34:560-563.
7. Meijer B, Bakker HH. Management of priapism in the newborn. Urology 2003; 61:224.
8. Brodie-Meijer CC, Diemont WL, Buijs PJ. Nefazodone-induced clitoral priapism. Int Clin Psychopharmacol 1999; 14:257-258.
9. Berk M, Acton M. Citalopram-associated clitoral priapism: a case series. Int Clin Psychopharmacol 1997; 12:121-122.
10. Doksat MK. Üçüncü Nesil Antidepresanları Kullanma Kılavuzu. İstanbul, 2008, s.97.
11. Tompson JW, Ware MR, Blasfield RK. Psychotropic medication and priapism: a compherensive rewiev. J Clin Psychiatry 1990; 51:430-433.
12. Dent LA. Citalopram-induced priapism. Pharma- cother 2002; 22:538-541.
13. Nordeng H, Lindemann R, Perminov KV, Reikvam A. Neonatal withdrawal syndrome after in utero exposure to selective serotonin reuptake inhibitors. Acta Paediatr 2001; 90:288-291.
14. Sanz EJ, De-las-Cuevas C, Kiuru A, Bate A, Edwards R. Selective serotonin reuptake inhibitors in pregnant women and neonatal withdrawal syndrome: a database analysis. Lancet 2005; 365:482-487.
15. Gentile S. Escitalopram late in pregnancy and while breast-feeding. Ann Pharmacother 2006; 40:1696-1697.
16. Hendrick V, Stowe ZN, Altshuler LL, Hwang S, Lee E, Haynes D. Placental passage of antidepressant medications. Am J Psychiatry 2003; 160:993-996.
17. Koren G, Matsiu D, Einarson A, Knoppert D, Steiner M. Is maternal use of selective serotonin reuptake inhibitors in the third trimester of pregnancy harmful to neonates? CMA 2005; 24:172.
18. Maciag D, Coppinger D, Paul AI. Evidence that the deficit in sexual behavior in adult rats neo- natally exposed to citalopram is a consequence of 5-HT1 receptor stimulation during development. Brain Res 2006; 1125:171-175.