Uzoma Ndukwe, Adrianne Parkey, Debopam Samanta, Abdelrahman Masri, Erin Willis
University of Arkansas for Medical Sciences.
United States
Cureus
Cureus 2026; 18:
DOI: 10.7759/cureus.108354
Abstract
Fenfluramine is approved for Dravet syndrome and Lennox-Gastaut syndrome (LGS) in children under two years of age and is increasingly used off-label for developmental and epileptic encephalopathies (DEEs). Due to the risk of pulmonary arterial hypertension (PAH) and valvular disease, serial echocardiographic monitoring is required. While fenfluramine-associated cardiac toxicity is well described in adults, data in pediatric patients, especially those under two years of age, remain limited. We report a child under two years of age with SCN1B-related DEE who developed asymptomatic fenfluramine-associated PAH after one year of treatment. Fenfluramine resulted in marked seizure reduction but was discontinued after the detection of PAH. Subsequent echocardiography demonstrated resolution of PAH, accompanied by worsening seizure burden. This case emphasizes the rare occurrence of fenfluramine-associated PAH in children under two years of age and underscores the importance of vigilant cardiac surveillance in this population.
Category
Class I. Drug-induced and Toxin-induced Pulmonary Hypertension
Age Focus: Pediatric Pulmonary Vascular Disease
Fresh or Filed Publication: Fresh (PHresh). Less than 1-2 years since publication
Article Access
Free PDF File or Full Text Article Available Through PubMed or DOI: Yes