Antimony in plasma and skin of patients with cutaneous leishmaniasis--relationship with side effects after treatment with meglumine antimoniate.
OBJECTIVE
To evaluate the levels of antimony in plasma and skin of patients being treated with pentavalent antimonials (Glucantime) and their relationship with side effects.


METHODS
We evaluated 19 patients treated endovenously at the conventional dose (20 mg Sb(v)/kg/day), two at a smaller dose (5 mg Sb(v)/kg/day) and three treated intralesionally (up to 4.0 ml/week). During treatment, patients underwent periodic blood exams and were interviewed weekly about the incidence of adverse symptoms. The levels of antimony in plasma and skin samples were determined by Inductively Coupled Plasma with Mass Spectrometry (ICP-MS).


RESULTS
The patients under conventional treatment presented a mean initial antimony plasma concentration of 3.39 microg/l; at the end of treatment, these levels were 0.21 before Glucantime application and 125.8 mg after Glucantime application. The mean antimony level in their skin at the end of the treatment was 9.24 microg/g. The main adverse symptoms were arthralgia and myalgia; laboratory results showed mainly lymphocytosis and eosinophilia.


CONCLUSIONS
We found some significant correlations between antimony concentrations, adverse symptoms and laboratory alterations, strengthening the hypothesis of a dose-dependent relationship between antimony concentration in plasma and skin and side effects.
Neves
Diana Brito da Justa
DB
University of Brasilia, Brasilia, DF, Brazil.
Caldas
Eloisa Dutra
ED
Sampaio
Raimunda Nonato Ribeiro
RN
D000328:Adult; D000965:Antimony / Q000032:analysis* / Q000097:blood; D000981:Antiprotozoal Agents / Q000008:administration & dosage / Q000009:adverse effects* / Q000378:metabolism; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D016773:Leishmaniasis, Cutaneous / Q000188:drug therapy* / Q000378:metabolism; D008297:Male; D013058:Mass Spectrometry; D008536:Meglumine / Q000008:administration & dosage / Q000009:adverse effects* / Q000378:metabolism; D000077485:Meglumine Antimoniate; D009942:Organometallic Compounds / Q000008:administration & dosage / Q000009:adverse effects* / Q000378:metabolism; D012867:Skin / Q000737:chemistry*; D016896:Treatment Outcome
D000981:Antiprotozoal Agents; D009942:Organometallic Compounds; D008536:Meglumine; D000077485:Meglumine Antimoniate; D000965:Antimony