Lysis syndrome during therapy of visceral leishmaniasis
Lysis syndrome during therapy of visceral leishmaniasis
复制标题
DOI：
10.1007/s15010-011-0202-9
复制
发表时间：
2012-04-01
期刊：
影响因子：
7.5
通讯作者：
Elisaf, M. S.
中科院分区：
文献类型：
--
作者：
Liberopoulos, E. N.;Kei, A. A.;Elisaf, M. S.
溶解综合征是一系列代谢紊乱，通常在快速增殖的恶性肿瘤开始化疗后出现（肿瘤溶解综合征）。本文报道了一个内脏利什曼病抗感染治疗开始后的肿瘤溶解样综合征。连续10例内脏利什曼病患者给予脂质体阿替霉素B。在治疗开始前以及治疗开始后4天和30天评价血清尿酸、磷酸盐、肌酐、血尿素氮、钾、钙和镁的水平。在治疗后第4天，观察到血清尿酸、磷酸盐、肌酐和血尿素氮的水平显著升高，而钙、钾和镁的水平没有显著改变。患者接受水化、尿碱化和根据需要给予别嘌呤醇治疗。尽管有些患者有残余损伤的证据，但1个月后代谢异常恢复。溶解综合征可能使内脏利什曼病的治疗复杂化。意识到这种并发症可以导致开始预防性治疗，以及在易感患者中早期识别和管理这种综合征。
Lysis syndrome is a constellation of metabolic disorders usually seen after the initiation of chemotherapy for rapidly proliferating malignancies (tumor lysis syndrome). Reported herein is a tumor lysis-like syndrome after the initiation of anti-infective therapy for visceral leishmaniasis.Ten consecutive patients with visceral leishmaniasis were administered liposomal amphotericin B. Levels of serum uric acid, phosphate, creatinine, blood urea nitrogen, potassium, calcium, and magnesium were evaluated prior to as well as 4 and 30 days following the initiation of treatment.During the 4th post-treatment day significant increases in the levels of serum uric acid, phosphate, creatinine, and blood urea nitrogen were seen, while the levels of calcium, potassium, and magnesium were not significantly altered. Patients were treated by hydration, urine alkalization, and administration of allopurinol as needed. A recovery of metabolic abnormalities was recorded 1 month later, although some patients had evidence of residual injury.A lysis syndrome may complicate the treatment of visceral leishmaniasis. Awareness of this complication can lead to the initiation of prophylactic treatment as well as to early recognition and management of this syndrome in susceptible patients.