title: [Severe megaloblastic anaemia by triamterene in a patient with alcoholic liver cirrhosis (author's transl)].
abstract: Mucosal ulceration and severe bone-marrow insufficiency with marked megaloblastic transformation occurred during treatment with triamterene in a patient with decompensated alcoholic liver cirrhosis and malnutrition. When the triamterene-containing preparation was stopped and folinic acid administered the haematological picture improved, but the patient died, with signs of hepatocellular insufficiency, of gastro-intestinal bleeding. The serum folic-acid level was markedly reduced due to the chronic malnutrition, while the vitamin B12 level was within normal limits. This observation indicates that when the pool of folic-acid coenzymes is reduced, triamterene can cause megaloblastic anaemia due to its folic-acid antagonism. Triamterene should, therefore, be given to patients with borderline folic-acid reservoirs, chronic alcoholism or during pregnancy, only under careful serial control of the blood picture.
mesh_terms: D000748:Anemia, Macrocytic / Q000139:chemically induced*; D000749:Anemia, Megaloblastic / Q000139:chemically induced*; D005492:Folic Acid / Q000097:blood; D006471:Gastrointestinal Hemorrhage / Q000150:complications; D006801:Humans; D008104:Liver Cirrhosis, Alcoholic / Q000097:blood / Q000150:complications*; D008297:Male; D008875:Middle Aged; D014223:Triamterene / Q000009:adverse effects*
chemical_list: D005492:Folic Acid; D014223:Triamterene
vernacular_title: Schwere megaloblastäre Anämie durch Triamteren bei einem Patienten mit alkoholischer Leberzirrhose.