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Faircloth JM, Bhatt ND, Chartan CA, Coleman RD, Villafranco N, Ruiz FE, Morales-Demori R, Whalen E, Ely E, Fombin R, Varghese NP. Corrigendum: Case report: Selexipag in pediatric pulmonary hypertension: initiation, transition, and titration. Front Pediatr 2023; 11:1275389. [PMID: 37675395 PMCID: PMC10479013 DOI: 10.3389/fped.2023.1275389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 08/10/2023] [Indexed: 09/08/2023] Open
Abstract
[This corrects the article DOI: 10.3389/fped.2023.1050508.].
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Affiliation(s)
- Jenna M. Faircloth
- Department of Pharmacy, Texas Children’s Hospital, Houston, TX, United States
| | - Neelam D. Bhatt
- Department of Pharmacy, Texas Children’s Hospital, Houston, TX, United States
| | - Corey A. Chartan
- Department of Pediatrics, Division of Critical Care and Pulmonology, Baylor College of Medicine, Texas Children’s Hospital, Houston, TX, United States
| | - Ryan D. Coleman
- Department of Pediatrics, Division of Critical Care and Pulmonology, Baylor College of Medicine, Texas Children’s Hospital, Houston, TX, United States
| | - Natalie Villafranco
- Department of Pediatrics, Division of Pulmonology, Baylor College of Medicine, Texas Children’s Hospital, Houston, TX, United States
| | - Fadel E. Ruiz
- Department of Pediatrics, Division of Pulmonology, Baylor College of Medicine, Texas Children’s Hospital, Houston, TX, United States
| | - Raysa Morales-Demori
- Department of Pediatrics, Division of Critical Care, Baylor College of Medicine, Texas Children’s Hospital, Houston, TX, United States
| | - Elise Whalen
- Department of Pulmonary Medicine, Texas Children’s Hospital, Houston, TX, United States
| | - Erin Ely
- Department of Pulmonary Medicine, Texas Children’s Hospital, Houston, TX, United States
| | - Rozmeen Fombin
- Department of Pulmonary Medicine, Texas Children’s Hospital, Houston, TX, United States
| | - Nidhy P. Varghese
- Department of Pediatrics, Division of Pulmonology, Baylor College of Medicine, Texas Children’s Hospital, Houston, TX, United States
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Faircloth JM, Bhatt ND, Chartan CA, Coleman RD, Villafranco N, Ruiz FE, Morales-Demori R, Whalen E, Ely E, Fombin R, Varghese NP. Case Report: Selexipag in pediatric pulmonary hypertension: Initiation, transition, and titration. Front Pediatr 2023; 11:1050508. [PMID: 36969286 PMCID: PMC10030494 DOI: 10.3389/fped.2023.1050508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 01/16/2023] [Indexed: 03/29/2023] Open
Abstract
Selexipag, a selective prostacyclin receptor agonist, is approved for treating pulmonary arterial hypertension in WHO Group 1 adult patients. Compared to parenteral prostacyclin formulations, selexipag offers a significant improvement in patient's and caregiver's quality of life because of its oral formulation, frequency of administration, and mechanism of action. Although experience in the pediatric population is limited to case reports in older adolescent patients and selexipag is not approved for use in the pediatric pulmonary hypertension population, many pediatric centers are expanding the use of this therapy to this population. We report our institution's experience in the use of selexipag to treat pulmonary hypertension in children under 10 years of age, between 10 and 30 kg. Seven patients were initiated on selexipag therapy including de novo initiation and transition from intravenous treprostinil to oral selexipag. All patients were on stable background therapy with phosphodiesterase-5 inhibitor and endothelin receptor antagonist therapies at baseline. All patients reached their planned goal selexipag dose during admission without the need for changes to the titration schedule and without hemodynamic deterioration. In our experience, oral selexipag is safe and well-tolerated in young pediatric patients with pulmonary hypertension. Based on our favorable experience, we developed an institution-specific selexipag process algorithm for continued successful use in the pediatric population.
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Affiliation(s)
- Jenna M. Faircloth
- Department of Pharmacy, Texas Children’s Hospital, Houston, TX, United States
| | - Neelam D. Bhatt
- Department of Pharmacy, Texas Children’s Hospital, Houston, TX, United States
| | - Corey A. Chartan
- Department of Pediatrics, Division of Critical Care and Pulmonology, Baylor College of Medicine, Texas Children’s Hospital, Houston, TX, United States
| | - Ryan D. Coleman
- Department of Pediatrics, Division of Critical Care and Pulmonology, Baylor College of Medicine, Texas Children’s Hospital, Houston, TX, United States
| | - Natalie Villafranco
- Department of Pediatrics, Division of Pulmonology, Baylor College of Medicine, Texas Children’s Hospital, Houston, TX, United States
| | - Fadel E. Ruiz
- Department of Pediatrics, Division of Pulmonology, Baylor College of Medicine, Texas Children’s Hospital, Houston, TX, United States
| | - Raysa Morales-Demori
- Department of Pediatrics, Division of Critical Care, Baylor College of Medicine, Texas Children’s Hospital, Houston, TX, United States
| | - Elise Whalen
- Department of Pulmonary Medicine, Texas Children’s Hospital, Houston, TX, United States
| | - Erin Ely
- Department of Pulmonary Medicine, Texas Children’s Hospital, Houston, TX, United States
| | - Rozmeen Fombin
- Department of Pulmonary Medicine, Texas Children’s Hospital, Houston, TX, United States
| | - Nidhy P. Varghese
- Department of Pediatrics, Division of Pulmonology, Baylor College of Medicine, Texas Children’s Hospital, Houston, TX, United States
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Ishizuka M, Zou W, Whalen E, Ely E, Coleman RD, Lopez-Terrada DH, Penny DJ, Fan Y, Varghese NP. Hereditary pulmonary arterial hypertension burden in pediatrics: A single referral center experience. Front Pediatr 2023; 11:1050706. [PMID: 37063688 PMCID: PMC10090688 DOI: 10.3389/fped.2023.1050706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 02/24/2023] [Indexed: 04/18/2023] Open
Abstract
Introduction Hereditary pulmonary arterial hypertension (HPAH) is a rare yet serious type of pulmonary arterial hypertension (PAH). The burden in the pediatric population remains high yet underreported. The objective of this study is to describe the distribution of mutations found on targeted PAH panel testing at a large pediatric referral center. Methods Children with PAH panel administered by the John Welsh Cardiovascular Diagnostic Laboratory at Texas Children's Hospital and Baylor College of Medicine in Houston, Texas between October 2012 to August 2021 were included into this study. Medical records were retrospectively reviewed for clinical correlation. Results Sixty-six children with PAH underwent PAH genetic testing. Among those, 9 (14%) children were found to have pathogenic mutations, 16 (24%) children with variant of unknown significance and 41 (62%) children with polymorphism (classified as likely benign and benign). BMPR2 mutation was the most common pathogenic mutation, seen in 6 of the 9 children with detected mutations. Hemodynamic studies showed higher pulmonary vascular resistance among those with pathogenic mutations than those without (17.4 vs. 4.6 Wood units). All children with pathogenic mutations had severe PAH requiring triple therapy. There were tendencies for higher lung transplantation rate but lower mortality among those with pathogenic mutations. Conclusions Abnormalities on genetic testing are not uncommon among children with PAH, although majority are of unclear significance. However, children with pathogenic mutations tended to present with more severe PAH requiring aggressive medical and surgical therapies. Genetic testing should be routinely considered due to consequences for treatment and prognostic implications. Larger scale population studies and registries are warranted to characterize the burden of HPAH in the pediatric population specifically.
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Affiliation(s)
- Maki Ishizuka
- Department of Pediatrics, Critical Care, Baylor College of Medicine, Texas Children’s Hospital, Houston, TX, United States
| | - Wenxin Zou
- Department of Pathology & Immunology, Baylor College of Medicine, Houston, TX, United States
- John Welsh Cardiovascular Diagnostic Laboratory, Division of Genomic Medicine, Department of Pathology, Texas Children’s Hospital, Houston, TX, United States
| | - Elise Whalen
- Department of Pediatrics, Pulmonology, Baylor College of Medicine, Texas Children’s Hospital, Houston, TX, United States
| | - Erin Ely
- Department of Pediatrics, Pulmonology, Baylor College of Medicine, Texas Children’s Hospital, Houston, TX, United States
| | - Ryan D. Coleman
- Department of Pediatrics, Critical Care, Baylor College of Medicine, Texas Children’s Hospital, Houston, TX, United States
| | - Dolores H. Lopez-Terrada
- Department of Pathology & Immunology, Baylor College of Medicine, Houston, TX, United States
- Division of Genomic Medicine, Department of Pathology, Texas Children’s Hospital, Houston, TX, United States
| | - Daniel J. Penny
- Department of Pediatrics, Cardiology, Baylor College of Medicine, Texas Children’s Hospital, Houston, TX, United States
| | - Yuxin Fan
- John Welsh Cardiovascular Diagnostic Laboratory, Division of Genomic Medicine, Department of Pathology, Texas Children’s Hospital, Houston, TX, United States
- Departments of Pathology & Immunology and Pediatrics-Cardiology, Baylor College of Medicine, Houston, TX, United States
- Correspondence: Yuxin Fan
| | - Nidhy P. Varghese
- John Welsh Cardiovascular Diagnostic Laboratory, Division of Genomic Medicine, Department of Pathology, Texas Children’s Hospital, Houston, TX, United States
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Peterson BL, Arnall M, Avedschmidt S, Beers D, Bell M, Burton S, Case M, Catellier M, Cina S, Cohle S, Collins K, Covach A, Downs J, Ely E, Ely S, Fajardo M, Fierro M, Fowler D, Frost R, Fudenberg J, Fusaro A, Gill J, Gilson T, Glenn C, Goldfogel G, Graham S, John Greenwell P, Ann Grossberg L, Gulledge C, Handler M, Hansma P, Harshbarger K, Hawes A, Hellman F, Heninger M, Hlavaty L, Hoyer P, Johnson D, Jorden M, Kelley D, Kesha K, Kohr R, Krywanczyk A, Lehman L, Lochmuller C, Luzi S, Mathew A, McDonough E, Mileusnic D, Miller E, Milroy C, Morrow P, Oliver W, Orvik A, Pandey M, Parsons T, Pfalzgraf R, Philip A, Poulos C, Prahlow J, Pustilnik S, Radisch D, Rao V, Raven K, Resk T, Ross K, Rudd T, Schmidt C, Schmunk G, Ann Sens M, Shelly M, Snell K, Sperry K, Stables S, Stahl-Herz J, Steckbauer M, Super M, Tarau M, Thogmartin J, Tormos L, Tse R, Utley S, Vega R, Williams K, Wolf B, Wright R. Commentary on: Dror IE, Melinek J, Arden JL, Kukucka J, Hawkins S, Carter J, et al. Cognitive bias in forensic pathology decisions. J Forensic Sci. https://doi.org/10.1111/1556-4029.14697. Epub 2021 Feb 20. J Forensic Sci 2021; 66:2541-2544. [PMID: 34498736 DOI: 10.1111/1556-4029.14843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Accepted: 07/19/2021] [Indexed: 11/30/2022]
Affiliation(s)
| | | | | | - Dean Beers
- Associates in Forensic Investigations, LLC, Larimer, CO, USA
| | | | | | - Mary Case
- St. Louis County Medical Examiner's Office, St. Louis, MO, USA
| | | | - Stephen Cina
- Cina and Cina Forensic Consulting, PC, Loveland, CO, USA
| | - Stephen Cohle
- Kent County Medical Examiner Office, Grand Rapids, MI, USA
| | | | - Adam Covach
- Fond du Lac County Medical Examiner's Office, Fond du Lac, WI, USA
| | | | - Erin Ely
- St. Louis County Medical Examiner's Office, St. Louis, MO, USA
| | - Susan Ely
- Office of the Chief Medical Examiner, New York, NY, USA
| | - Mark Fajardo
- Riverside County Sheriff-Coroner's Office, Perris, CA, USA
| | | | | | | | - John Fudenberg
- Clark County Office of the Coroner/Medical Examiner, Las Vegas, NV, USA
| | - Aldo Fusaro
- Montana State Medical Examiner, Missoula, MT, USA
| | - James Gill
- Connecticut Office of the Chief Medical Examiner, Farmington, CT, USA
| | - Thomas Gilson
- Cuyahoga County Medical Examiner's Office, Cleveland, OH, USA
| | - Charles Glenn
- North Forensic Pathology Service, Auckland, New Zealand
| | - Gary Goldfogel
- Whatcom County Medical Examiner Office, Bellingham, WA, USA
| | | | | | | | | | - Michael Handler
- Neuropathology & Forensic Pathology Consulting Inc, Overland Park, KS, USA
| | | | | | - Amy Hawes
- Office of the Tennessee State Medical Examiner, Clinton, TN, USA
| | | | | | - Leigh Hlavaty
- Wayne County Medical Examiner's Office, Detroit, MI, USA
| | | | | | - Michelle Jorden
- Santa Clara County Medical Examiner's Office, San Jose, CA, USA
| | - Douglas Kelley
- Milwaukee County Medical Examiner's Office, Milwaukee, WI, USA
| | - Kilak Kesha
- North Forensic Pathology Service, Auckland, New Zealand
| | - Roland Kohr
- Terre Haute Regional Hospital, Terre Haute, IN, USA
| | | | - Lee Lehman
- Montgomery County Coroner's Office, Dayton, OH, USA
| | | | - Scott Luzi
- Anatomic, Clinical, and Forensic Pathology Services, Escondido, CA, USA
| | - Ashley Mathew
- Office of the State Medical Examiner, Louisville, KY, USA
| | | | | | | | - Chris Milroy
- Division of Anatomic Pathology, The Ottawa Hospital, Ottawa, Canada
| | - Paul Morrow
- North Forensic Pathology Service, Auckland, New Zealand
| | - William Oliver
- Knox County Regional Forensic Center, Knoxville, TN, USA
| | - Andrea Orvik
- Montana Medical Examiner's Office, Billings, MT, USA
| | | | - Thomas Parsons
- Lubbock County Medical Examiner's Office, Lubbock, TX, USA
| | | | - Abraham Philip
- Cobb County Medical Examiner's Office, Marietta, GA, USA
| | | | - Joe Prahlow
- Western Michigan University Homer Stryker MD School of Medicine, Kalamazoo, MI, USA
| | | | | | - Valerie Rao
- District 12 Medical Examiner's Office, Sarasota, FL, USA
| | | | | | - Karen Ross
- Fort Bend County Medical Examiner's Office, Rosenberg, TX, USA
| | | | - Carl Schmidt
- Wayne County Medical Examiner's Office, Detroit, MI, USA
| | | | - Mary Ann Sens
- University of North Dakota School of Medicine and Health Sciences, Grand Forks, ND, USA
| | - Mark Shelly
- Maricopa County Office of the Medical Examiner, Phoenix, AZ, USA
| | - Kenneth Snell
- Minnehaha County Coroner/Medical Examiner's Office, Sioux Falls, SD, USA
| | - Kris Sperry
- Forensic Pathology Consultant, Peachtree City, GA, USA
| | - Simon Stables
- North Forensic Pathology Service, Auckland, New Zealand
| | - Jay Stahl-Herz
- New York City Office of the Chief Medical Examiner, Brooklyn, NY, USA
| | | | - Mark Super
- Super Forensic Pathology, El Dorado Hills, CA, USA
| | - Marius Tarau
- Jackson County Medical Examiner's Office, Kansas City, MO, USA
| | | | - Lee Tormos
- District 15 Medical Examiner's Office, Palm Beach, FL, USA
| | - Rexson Tse
- North Forensic Pathology Service, Auckland, New Zealand
| | - Suzanne Utley
- District 12 Medical Examiner's Office, Sarasota, FL, USA
| | - Russell Vega
- District 12 Medical Examiner's Office, Sarasota, FL, USA
| | | | - Barbara Wolf
- Districts 5 & 24 Medical Examiner's Office, Leesburg, FL, USA
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