Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Perinatal/Neonatal Case Presentation
  • Published:

Perinatal/Neonatal Case Presentation

Successful treatment of neonatal respiratory failure caused by a novel surfactant protein C p.Cys121Gly mutation with hydroxychloroquine

Abstract

SFTPC (surfactant protein C) mutations resulting in SP-C deficiency causing ongoing respiratory failure in the neonatal period represent a rare entity. We report a full-term female infant who developed respiratory distress and respiratory failure shortly after birth. From the first day of life the infant was mechanically ventilated. Application of exogenous surfactant or cortisone did not lead to any clinical improvement. Genetic analysis identified a novel SFTPC mutation as the cause of her lung disease. The patient was diagnosed as heterozygous for a p.Cys121Gly/C121G substitution encoded by exon 4, which could not be detected in both parents. Experimental therapy with hydroxychloroquine resulted in a significant clinical improvement within 2 weeks time. Mechanical ventilation was no longer needed, and the patient was discharged without additional oxygen demand. The patient remained well under therapy till the age of 6 months. After that time, the therapy was successfully discontinued.

This is a preview of subscription content, access via your institution

Access options

Buy this article

Prices may be subject to local taxes which are calculated during checkout

Figure 1
Figure 2
Figure 3

Similar content being viewed by others

References

  1. Nogee LM, Dunbar AE, Wert SE, Askin F, Hamvas A, Whitsett JA . N Engl J Me. d 2001; 344: 573–579.

    CAS  Google Scholar 

  2. Poterjoy BS, Vibert Y, Sola-Visner M, McGowan J, Visner G, Nogee LM J Perinatol 2010; 30 (2): 151–153.

    Article  CAS  Google Scholar 

  3. Soraisham AS, Tierney AJ, Amin HJ . Neonatal respiratory failure associated with mutation in the surfactant protein C gene. J Perinatol 2006; 26 (1): 67–70.

    Article  CAS  Google Scholar 

  4. Hamvas A, Cole FS, Nogee LM . Genetic disorders of surfactant proteins. Neonatology 2007; 91 (4): 311–317.

    Article  CAS  Google Scholar 

  5. Kabore AF, Wang WJ, Russo SJ, Beers MF . Biosynthesis of surfactant protein C: characterization of aggresome formation by EGFP chimeras containing propeptide mutants lacking conserved cysteine residues. J Cell Sci 2001; 114 (2): 293–302.

    CAS  PubMed  Google Scholar 

  6. Moreno A, Maestre J, Balcells J, Marhuenda C, Cobos N, Roman A et al. Lung transplantation in young infants with interstitial pneumonia. Transplant Proc 2003; 35 (5): 1951–1953.

    Article  CAS  Google Scholar 

  7. Hamvas A, Cole FS, deMello DE, Moxley M, Whitsett JA, Colten HR et al. Surfactant protein B deficiency: antenatal diagnosis and prospective treatment with surfactant replacement. J Pediatr 1994; 123 (3): 356–361.

    Article  Google Scholar 

  8. Rosen DM, Waltz DA . Hydroxychloroquine and surfactant protein C deficiency. N Engl J Med 2005; 352 (2): 207–208.

    Article  CAS  Google Scholar 

  9. Dinwiddie R, Sharief N, Crawford O . Idiopathic interstitial pneumonitis in children: a national survey in the United Kingdom and Ireland. Pediatr Pulmonol 2002; 34 (1): 23–29.

    Article  CAS  Google Scholar 

  10. Beers MF, Hawkins A, Maguire JA, Kotorashvili A, Zhao M, Newitt JL et al. A nonaggregating surfactant protein C mutant is misdirected to early endosomes and disrupts phospholipid recycling. Traffic 2011; 12 (9): 1196–1210.

    Article  CAS  Google Scholar 

  11. Gabler NB, Duan N, Vohra S, Kravitz RL . N-of-1 trials in the medical literature: a systematic review. Med Care 2011; 49 (8): 761–768.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to N Hepping.

Ethics declarations

Competing interests

The authors declare no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Hepping, N., Griese, M., Lohse, P. et al. Successful treatment of neonatal respiratory failure caused by a novel surfactant protein C p.Cys121Gly mutation with hydroxychloroquine. J Perinatol 33, 492–494 (2013). https://doi.org/10.1038/jp.2012.131

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/jp.2012.131

Keywords

Search

Quick links