Case report: Acute renal injury as a result of liposomal amphotericin B treatment in sodium stibogluconate unresponsive visceral leishmaniasis

Am J Trop Med Hyg. 2011 Dec;85(6):1035-7. doi: 10.4269/ajtmh.2011.11-0449.

Abstract

We report an unusual case of visceral leishmaniasis occurring in a patient from Sichuan China. The patient presented with a remitting fever, anemia, and pancytopenia. The case was confirmed as visceral leishmaniasis by microscopical detection of the Leishmania species amastigote in bone marrow aspirate. The patient was treated with 10 mg/kg/day of sodium stibogluconate for 5 days, with no therapeutic response. As a result, the patient was treated with liposomal amphotericin B (LAB) at 10 mg/day as an initial dosage. After treatment with an increasing drug dosage for 7 days, acute renal injury was evident as indicated by increased serum creatinine and urea nitrogen. LAB administration was discontinued until serum creatinine and serum urea nitrogen regressed on Day 15. Two maintenance treatments of 100 mg/day LAB were given on Days 19 and 26 (total 870 mg, 14.5 mg/kg). Bone marrow aspirate and clinical examination suggested total remission.

Publication types

  • Case Reports

MeSH terms

  • Acute Kidney Injury / chemically induced*
  • Adult
  • Amphotericin B / adverse effects*
  • Amphotericin B / therapeutic use
  • Antimony Sodium Gluconate / therapeutic use*
  • Antiprotozoal Agents / adverse effects*
  • Antiprotozoal Agents / therapeutic use
  • Drug Resistance
  • Humans
  • Leishmania donovani / drug effects*
  • Leishmaniasis, Visceral / drug therapy*
  • Male

Substances

  • Antiprotozoal Agents
  • liposomal amphotericin B
  • Amphotericin B
  • Antimony Sodium Gluconate