Pathology & Oncology Research

, Volume 25, Issue 2, pp 487–492 | Cite as

Antithymocyte Globuline Therapy and Bradycardia in Children

  • Krisztián KállayEmail author
  • Dávid Zakariás
  • Katalin Csordás
  • Gábor Benyó
  • Csaba Kassa
  • János Sinkó
  • Anita Stréhn
  • Orsolya Horváth
  • Barna Vásárhelyi
  • Gergely Kriván
Original Article


In antithymocyte globulin (ATG) treated patients occasionally bradycardia has been noticed. Therefore, we retrospectively analyzed the occurrence of bradycardia in ATG-treated children. Using medical records between 2007 and 2012 we identified children undergoing a combined therapy with ATG and glucocorticoids (ATG group, n = 22). The incidence of bradycardia was compared to that registered in children treated with glucocorticoids alone (glucocorticoid alone group, n = 21). Heart rates (HR) were registered before and on days 0–3, 4–7 and 8–14 after the ATG or steroid administration. The rate of bradycardic episodes was higher during ATG therapy than in the steroid alone group, while severe bradycardia occurred only in the ATG group (97 versus 32, p = 0.0037, and 13 versus 0, p = 0.0029, respectively). There was an interaction between the time and treatment group on HR (p = 0.046). Heart rates in ATG and steroid alone groups differed significantly on day 0–3 and day 4–7 (p = 0.046, p = 0.006, respectively). Within the ATG group HR was lower on days 4–7 compared to the days before and the days 8–14 values (p < 0.001, 95%CI: 0.020–0.074). These findings indicate that transient asymptomatic bradycardia is probably more common with ATG therapy than previously reported. HR should be closely monitored during and after ATG therapy.


Antithymocyte globulin ATG Bradycardia Children 


Author Contributions

All authors have contributed substantially in the conception and design of the study. They all participated actively in the writing and approving of the manuscript.

Compliance with Ethical Standards

Conflict of Interest

The authors report no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study formal consent is not required.


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Copyright information

© Arányi Lajos Foundation 2018

Authors and Affiliations

  • Krisztián Kállay
    • 1
    Email author
  • Dávid Zakariás
    • 1
  • Katalin Csordás
    • 1
  • Gábor Benyó
    • 1
  • Csaba Kassa
    • 1
  • János Sinkó
    • 1
  • Anita Stréhn
    • 1
  • Orsolya Horváth
    • 1
  • Barna Vásárhelyi
    • 2
  • Gergely Kriván
    • 1
  1. 1.Pediatric Hematology and Stem Cell Transplantation UnitUnited St. István and St. László HospitalBudapestHungary
  2. 2.Department of Laboratory MedicineSemmelweis UniversityBudapestHungary

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