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Cited by 246Pregnancy and Medication ImpactPharmacological Effects and Toxicity StudiesFetal and Pediatric Neurological Disorders

Fluconazole-induced congenital anomalies in three infants

Pursley, T. J., Blomquist, I. K., Abraham, J., Andersen, H. F., Bartley, J. A.·1996·Clinical Infectious Diseases
DOI 10.1093/clinids/22.2.336
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Abstract

Fluconazole has been associated with various teratisms in animals, including craniofacial ossification defects, thin, wavy ribs, and renal pelvis defects. We describe three infants born to women who were receiving fluconazole through or beyond the first trimester of pregnancy. All of the infants had congenital anomalies; no other drug was implicated. Only one of the three infants survived. Their anomalies, similar to those observed in animal studies, were largely craniofacial, skeletal (i.e., thin, wavy ribs and ossification defects), and cardiac. One of these infants was previously reported as having Antley-Bixler syndrome; however, given the chronology described herein and the similarity of this infant to the others, we conclude that her deformities also represent the potent teratogenic effect of fluconazole.

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Crossref · 10.1093/clinids/22.2.336

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  • ABS has been reported in infants whose mothers ingested the antifungal agent fluconazole; fluconazole acts by inhibiting fungal CYP51 activity.

    “Second, ABS has been reported in infants whose mothers ingested the antifungal agent fluconazole (338, 339); flu-conazole acts by inhibiting fungal CYP51 activity.”

    From The Molecular Biology, Biochemistry, and Physiology of Human Steroidogenesis and Its Disorders (2011) · cites this paper as [338]

    The introduction says one fluconazole-exposed infant’s malformations were initially attributed to Antley-Bixler syndrome (ABS). The Discussion explicitly rejects ABS for that infant and the infants in this report, stating that features absent from the cases exclude the diagnosis. The CYP51 statement follows the citation and is not judged as attributed to this paper. (LLM, conf=0.86)

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Cites

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Research works printed but not linked: 6

  1. [5]5. Galgiani IN. Coccidioidomycosis. West J Med 1993; 159:153-71.
  2. [10]10. Catanzaro A, Fierer J, Friedman PJ. Fluconazole in the treatment ofpersis- tent coccidioidomycosis. Chest 1990;97:666-9.
  3. [14]14. Tiboni GM, Scott WJ. Teratological interaction between acetazolamide and antifungal azole derivatives [abstract no P25]. In: Abstracts of the 31st annual meeting of the Teratology Society-3rd annual meeting of the International Federation of Teratology Societies (Boca Raton, Florida). Teratology 1991;43:424.
  4. [15]15. Buttar HS, Moffatt JR, Bura C. Pregnancy outcome in ketoconazole- treated rats and mice [abstract no PI17]. In: Abstracts of the 31st annual meeting of the Teratology Society-3rd annual meeting of the Interna- tional Federation ofTeratology Societies (Boca Raton, Florida). Teratol- ogy 1991;43:424.
  5. [17]17. Van Cauteren H, Coussement W, Vandenberghe J, Herin V, Vanparys P, Marsboom R. The toxicological properties of itraconazole. In: Fromtling RA, et aI., eds. Recent trends in the discovery, development and evalua- tion of antifungal agents. Telesymposia proceedings. Barcelona, Spain: J. R. Prous, 1987.
  6. [21]21. Jacobson RL, Dignan PS, Miodovnik M, Siddiqi TA. Antley-Bixler syn- drome. J Ultrasound Med 1992; 11: 161-4.

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Authors
Pursley, T. J., Blomquist, I. K., Abraham, J., Andersen, H. F., & Bartley, J. A.
Affiliations
  • Loma Linda University (US)
  • Loma Linda University Medical Center (US)
Corresponding author
Blomquist, I. K.
ORCID
Andersen, H. F.
Venue
Clinical Infectious Diseases
Publisher
Oxford University Press (OUP)
Published
1996-02-01
Volume
22
Issue
2
Pages
336-340
ISSN
  • 1058-4838 (ISSN-L)
  • 1537-6591
DOI
10.1093/clinids/22.2.336
OpenAlex
W1994951476
Semantic Scholar
485fdd2c7594e61ebb4195bacaf7aecf3c071e86
Cited by
246
References
16
Citations by year
2026: 1 · 2025: 4 · 2024: 3 · 2023: 9 · 2022: 3 · 2021: 5 · 2020: 7 · 2019: 8 · 2018: 6 · 2017: 8 · 2016: 11 · 2015: 8 · 2014: 15 · 2013: 11 · 2012: 8
FWCI
10.82
Type
journal article
Language
en
Open access
closed
Locations
  • Clinical Infectious Diseases (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Pregnancy and Medication Impact
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Pharmacological Effects and Toxicity Studies
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Fetal and Pediatric Neurological Disorders
Keywords
fluconazole, teratogenicity, congenital malformations, prenatal drug exposure, craniofacial anomalies, skeletal abnormalities, cardiac anomalies, Antley-Bixler syndrome, first trimester, infants
MeSH terms
Abnormalities, Drug-Induced, Adult, Antifungal Agents, Bone and Bones, Coccidioidomycosis, Face, Female, Heart Defects, Congenital, Humans, Infant, Newborn, Male, Pregnancy, Pregnancy Complications, Infectious, Pregnancy Trimester, First, Skull, Fluconazole, Meningitis, Fungal

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