Hyperkalaemia with renal tubular dysfunction by sulfamethoxazole-trimethoprim for Pneumocystis carinii pneumonia in patients with lymphoid malignancy.
Hyperkalaemia with renal tubular dysfunction by oral therapy of sulfamethoxazole-trimethoprim (co-trimoxazole) is described in 2 elderly Japanese patients with lymphoid malignancy, who developed Pneumocystis carinii pneumonia and improved. A high dose of cotrimoxazole induced hyperkalaemia with the elevation of serum creatinine and blood urea, and increased urinary N-acetyl glucosaminase after several days of the drug administration in these patients; one patient became unconscious. Discontinuation of co-trimoxazole normalized serum potassium level and symptoms. A repeated low dose of the drug induced hyperkalaemia. Before the treatment of co-trixomazole, their serum levels of creatinine showed upper limits of normal ranges. In the present study, our cases suggested that patients receiving a high dose of co-trimoxazole should be evaluated for these potential complications during a course of treatment, particularly in elderly patients with preexisting renal dysfunction.
Funai
N
N
Department of Internal Medicine, Saga Medical School, Japan.
Shimamoto
Y
Y
Matsuzaki
M
M
Watanabe
M
M
Tokioka
T
T
Sueoka
E
E
Suga
K
K
Ono
K
K
Sano
M
M
Yamaguchi
M
M
D000368:Aged; D006801:Humans; D006947:Hyperkalemia / Q000139:chemically induced*; D007010:Hyponatremia / Q000139:chemically induced; D007674:Kidney Diseases / Q000097:blood / Q000139:chemically induced*; D007684:Kidney Tubules / Q000187:drug effects*; D015458:Leukemia, T-Cell / Q000150:complications*; D008228:Lymphoma, Non-Hodgkin / Q000150:complications*; D008297:Male; D008875:Middle Aged; D011020:Pneumonia, Pneumocystis / Q000150:complications / Q000188:drug therapy*; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000009:adverse effects*
D015662:Trimethoprim, Sulfamethoxazole Drug Combination