PDF(Pubmed)
Abstract：
UNASSIGNED: Nephrotoxicity is the most frequent serious adverse effect associated with amphotericin B deoxycholate treatment, for this reason, in recent years it has been relegated from routine clinical practice and replaced by the new liposomal formulations that have less nephrotoxicity. Nevertheless, dyselectrolytemia are a frequent adverse effect of the use of liposomal amphotericin B that usually are resolved with the withdrawal of the drug.
UNASSIGNED: We present a preterm neonate of 25 weeks gestation, with preserved renal function and most electrolytes within normal limits for gestational age except for mild hyponatremia in the first month of life. Due to an infection of the central nervous system and growth of Candida albicans, he required treatment with endovenous liposomal amphotericin B as well as intrathecal amphotericin B deoxycholate showing severe hydroelectrolyte disturbances and clinical worsening compatible with possible tubulopathy showing hypokalemia and severe hyponatremia a few days after starting treatment that persisted over time even after withdrawal of both drugs. Subsequently to the main alterations described, hypomagnesemia, hypophosphatemia, glycosuria and tubular proteinuria were also observed. Calcium levels remained stable after amphotericin B administration and did not require supplementation. In preterm or low birth weight newborns who present unjustified, severe and difficult to correct hydroelectrolyte disturbances despite the usual treatment, a possible tubulopathy should be considered, whether hereditary, primary or secondary to toxins or drugs.
UNASSIGNED: We present the first case reported in a neonate in whom dyselectrolithemia has been maintained over time after withdrawal of liposomal amphotericin B.
UNASSIGNED: We present a preterm neonate of 25 weeks gestation, with preserved renal function and most electrolytes within normal limits for gestational age except for mild hyponatremia in the first month of life. Due to an infection of the central nervous system and growth of Candida albicans, he required treatment with endovenous liposomal amphotericin B as well as intrathecal amphotericin B deoxycholate showing severe hydroelectrolyte disturbances and clinical worsening compatible with possible tubulopathy showing hypokalemia and severe hyponatremia a few days after starting treatment that persisted over time even after withdrawal of both drugs. Subsequently to the main alterations described, hypomagnesemia, hypophosphatemia, glycosuria and tubular proteinuria were also observed. Calcium levels remained stable after amphotericin B administration and did not require supplementation. In preterm or low birth weight newborns who present unjustified, severe and difficult to correct hydroelectrolyte disturbances despite the usual treatment, a possible tubulopathy should be considered, whether hereditary, primary or secondary to toxins or drugs.
UNASSIGNED: We present the first case reported in a neonate in whom dyselectrolithemia has been maintained over time after withdrawal of liposomal amphotericin B.
摘要：
未经证实：肾毒性是两性霉素B脱氧胆酸盐治疗最常见的严重不良反应，出于这个原因,近年来，它已从常规临床实践中降级，并被肾毒性较小的新脂质体制剂所取代。然而，使用脂质体两性霉素B的常见不良反应通常随着停药而解决。
未经证实：我们介绍了一个妊娠25周的早产新生儿，除了出生后第一个月的轻度低钠血症外，肾功能保持不变，大多数电解质在胎龄正常范围内。由于中枢神经系统的感染和白色念珠菌的生长，他需要接受静脉内脂质体两性霉素B和鞘内注射两性霉素B脱氧胆酸盐治疗,这显示出严重的水电解质紊乱和临床恶化,这与开始治疗后几天可能出现的肾小管病变相一致,这些病变显示低钾血症和严重低钠血症,即使在两种药物停药后,这种情况也会随着时间的推移而持续.在描述的主要改动之后，低镁血症,低磷酸盐血症,还观察到糖尿和肾小管性蛋白尿。两性霉素B给药后钙水平保持稳定，不需要补充。在早产或低出生体重的新生儿中，尽管常规治疗，但严重且难以纠正的水电解质紊乱，应该考虑可能的肾小管病，无论是遗传性的，主要的或次要的毒素或药物。
未经证实：我们介绍了一个妊娠25周的早产新生儿，除了出生后第一个月的轻度低钠血症外，肾功能保持不变，大多数电解质在胎龄正常范围内。由于中枢神经系统的感染和白色念珠菌的生长，他需要接受静脉内脂质体两性霉素B和鞘内注射两性霉素B脱氧胆酸盐治疗,这显示出严重的水电解质紊乱和临床恶化,这与开始治疗后几天可能出现的肾小管病变相一致,这些病变显示低钾血症和严重低钠血症,即使在两种药物停药后,这种情况也会随着时间的推移而持续.在描述的主要改动之后，低镁血症,低磷酸盐血症,还观察到糖尿和肾小管性蛋白尿。两性霉素B给药后钙水平保持稳定，不需要补充。在早产或低出生体重的新生儿中，尽管常规治疗，但严重且难以纠正的水电解质紊乱，应该考虑可能的肾小管病，无论是遗传性的，主要的或次要的毒素或药物。
