Endocrine and metabolic manifestations of invasive fungal infections and systemic antifungal treatment.
Systemic fungal infections are increasingly reported in immunocompromised patients with hematological malignancies, recipients of bone marrow and solid organ allografts, and patients with AIDS. Mycoses may infiltrate endocrine organs and adversely affect their function or produce metabolic complications, such as hypopituitarism, hyperthyroidism or hypothyroidism, pancreatitis, hypoadrenalism, hypogonadism, hypernatremia or hyponatremia, and hypercalcemia. Antifungal agents used for prophylaxis and/or treatment of mycoses also have adverse endocrine and metabolic effects, including hypoadrenalism, hypogonadism, hypoglycemia, dyslipidemia, hypernatremia, hypocalcemia, hyperphosphatemia, hyperkalemia or hypokalemia, and hypomagnesemia. Herein, we review how mycoses and conventional systemic antifungal treatment can affect the endocrine system and cause metabolic abnormalities. If clinicians are equipped with better knowledge of the endocrine and metabolic complications of fungal infections and antifungal therapy, they can more readily recognize them and favorably affect outcome.
Lionakis
Michail S
MS
Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas M D Anderson Cancer Center, Houston, TX 77030, USA.
Samonis
George
G
Kontoyiannis
Dimitrios P
DP
D000307:Adrenal Gland Diseases / Q000209:etiology; D000935:Antifungal Agents / Q000009:adverse effects* / Q000494:pharmacology; D004700:Endocrine System Diseases / Q000209:etiology* / Q000517:prevention & control; D019317:Evidence-Based Medicine; D019337:Hematologic Neoplasms / Q000150:complications; D006801:Humans; D008659:Metabolic Diseases / Q000209:etiology* / Q000517:prevention & control; D009181:Mycoses / Q000150:complications / Q000188:drug therapy*; D010182:Pancreatic Diseases / Q000209:etiology; D010279:Parathyroid Diseases / Q000209:etiology; D010900:Pituitary Diseases / Q000209:etiology; D012307:Risk Factors; D013959:Thyroid Diseases / Q000209:etiology
D000935:Antifungal Agents