Adverse facial edema associated with off-label use of recombinant human bone morphogenetic protein–2 in cranial reconstruction for craniosynostosis
Case report
M. Mohsin Shah, M.D.1, Matthew D. Smyth, M.D.2, and Albert S. Woo, M.D.3
1Division of Neurosurgery, University of Missouri–Columbia; and 2Department of Neurosurgery and 3Division of Plastic and Reconstructive Surgery, St. Louis Children's Hospital, Washington University in St. Louis, Missouri
Abbreviations used in this paper: BMP = bone morphogenetic protein; FDA = Food and Drug Administration; rhBMP-2 = recombinant human BMP–2.
Address correspondence to: M. Mohsin Shah, M.D., Division of Neurosurgery, University of Missouri–Columbia, One Hospital Drive, N521, Columbia, Missouri 65203. email:
mmohsinshah@gmail.com.
DOI: 10.3171/PED/2008/1/3/255
The authors present a case of scalp and facial edema following craniofacial reconstruction for metopic craniosynostosis in which recombinant human bone morphogenetic protein–2 (rhBMP-2) was used to treat cranial defects related to the frontoorbital reconstruction. The extent of swelling, the onset, and duration were unusual for such cases and suggested a possible role of rhBMP-2 in inducing a local inflammatory response. The edema rapidly resolved after the patient underwent surgery to remove the rhBMP-2 implants.
KEYWORDS:bone morphogenetic protein; craniofacial surgery; craniosynostosis repair; metopic synostosis.
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