[Cyanotic Raynaud phenomenon as a side effect of Amphotericin B].
Despite its wellknown adverse effects, Amphoterin B is an integral part of any supportive therapy in haematology/oncology. We report on a thirteen year old boy with acute myelogenous leukemia and suspected fungoid pneumonia. Shortly after iv or inhalative application of Amphotericin B he repeatedly presented with a Raynaud phenomenon of his toes, which ceased after switching to Ambisome (liposomal unilamellar encapsuled Amphotericin B). Since there is evidence that thromboxane A2-mediated arteriolar spasms of renal vessels provoke the wellknown increase in serum creatinine after Amphotericin B, and in different species pulmonal vasoconstriction has been observed, we speculate that a similar mechanism is responsible for the observed Raynaud phenomenon. Thus we suggest inhibitors of prostaglandine synthesis for therapy.
Abteilung Pädiatrische Hämatologie/Onkologie, Universitätskinderkinik.
B
B
Zernikow
G
G
Fleischack
C
C
Hasan
U
U
Bode
D000293:Adolescent; D000666:Amphotericin B / Q000008:administration & dosage / Q000009:adverse effects*; D000935:Antifungal Agents / Q000008:administration & dosage / Q000009:adverse effects*; D002177:Candidiasis / Q000188:drug therapy*; D006801:Humans; D007511:Ischemia / Q000139:chemically induced* / Q000175:diagnosis; D015470:Leukemia, Myeloid, Acute / Q000150:complications; D008172:Lung Diseases, Fungal / Q000188:drug therapy*; D008297:Male; D009894:Opportunistic Infections / Q000188:drug therapy*; D011928:Raynaud Disease / Q000139:chemically induced* / Q000175:diagnosis; D014034:Toes / Q000098:blood supply*
D000935:Antifungal Agents; D000666:Amphotericin B