Severe adverse reactions to meglumine antimoniate in the treatment of visceral leishmaniasis: a report of 13 cases in the southwestern region of Brazil.
Antimony-based medications continue to be the chosen drug for visceral leishmaniasis treatment in most countries. Pentavalent antimony compounds are highly effective but frequently have adverse reactions. Although toxic effects are almost always reversible, some of them can be severe. Clinical and laboratory data of 13 patients who developed severe adverse reactions to meglumine antimoniate in a teaching hospital in southwestern Brazil in 2004-2005 were analysed. Most patients were adults (10/13), mainly at the age of 50 or older (4/13). The main severe adverse reactions were renal failure (eight episodes), pancreatitis (six episodes) and hepatic failure/hepatitis (five episodes). Six patients died in the period; all presented acute renal failure and four presented hepatic failure. Meglumine antimoniate can cause severe reactions, which can lead to death if not promptly identified. Further studies are warrented on the effect of less toxic drugs.
Oliveira
Ana Lúcia Lyrio de
AL
Rua Rui Barbosa, 4273 Campo Grande, MS 79002-368, Brasil. allyrio@yahoo.com.br
Brustoloni
Yvone Maia
YM
Fernandes
Thiago Dias
TD
Dorval
Maria Elizabeth Cavalheiros
ME
Cunha
Rivaldo Venâncio da
RV
Bóia
Márcio Neves
MN
D000293:Adolescent; D000328:Adult; D000981:Antiprotozoal Agents / Q000009:adverse effects*; D005260:Female; D006321:Heart / Q000187:drug effects; D006801:Humans; D007898:Leishmaniasis, Visceral / Q000188:drug therapy*; D017093:Liver Failure / Q000139:chemically induced; D008297:Male; D008536:Meglumine / Q000009:adverse effects*; D000077485:Meglumine Antimoniate; D008875:Middle Aged; D009942:Organometallic Compounds / Q000009:adverse effects*; D010195:Pancreatitis / Q000139:chemically induced; D051437:Renal Insufficiency / Q000139:chemically induced
D000981:Antiprotozoal Agents; D009942:Organometallic Compounds; D008536:Meglumine; D000077485:Meglumine Antimoniate