Anais Brasileiros de Dermatologia (Jul 2019)

American tegumentary leishmaniasis: severe side effects of pentavalent antimonial in a patient with chronic renal failure

  • Sílvio Alencar Marques,
  • Maira Renata Merlotto,
  • Paulo Müller Ramos,
  • Mariangela Esther Alencar Marques

DOI
https://doi.org/10.1590/abd1806-4841.20198388
Journal volume & issue
Vol. 94, no. 3
pp. 355 – 357

Abstract

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Abstract: Pentavalent antimonials are the first-line drug treatment for American tegumentary leishmaniasis. We report on a patient with chronic renal failure on hemodialysis who presented with cutaneous lesions of leishmaniasis for four months. The patient was treated with intravenous meglumine under strict nephrological surveillance, but cardiotoxicity, acute pancreatitis, pancytopenia, and cardiogenic shock developed rapidly. Deficient renal clearance of meglumine antimoniate can result in severe toxicity, as observed in this case. These side effects are related to cumulative plasma levels of the drug. Therefore, second-line drugs like amphotericin B are a better choice for patients on dialysis.

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