title: Hyperkalaemia with renal tubular dysfunction by sulfamethoxazole-trimethoprim for Pneumocystis carinii pneumonia in patients with lymphoid malignancy.
abstract: 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.
authors.affiliation: Department of Internal Medicine, Saga Medical School, Japan.
authors.forename: N
authors.initials: N
authors.lastname: Funai
authors.forename: Y
authors.initials: Y
authors.lastname: Shimamoto
authors.forename: M
authors.initials: M
authors.lastname: Matsuzaki
authors.forename: M
authors.initials: M
authors.lastname: Watanabe
authors.forename: T
authors.initials: T
authors.lastname: Tokioka
authors.forename: E
authors.initials: E
authors.lastname: Sueoka
authors.forename: K
authors.initials: K
authors.lastname: Suga
authors.forename: K
authors.initials: K
authors.lastname: Ono
authors.forename: M
authors.initials: M
authors.lastname: Sano
authors.forename: M
authors.initials: M
authors.lastname: Yamaguchi
mesh_terms: 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*
chemical_list: D015662:Trimethoprim, Sulfamethoxazole Drug Combination