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Pancreatic toxicity after liposomal amphotericin B
Author(s) -
StuecklinUtsch A.,
Hasan C.,
Bode U.,
Fleischhack G.
Publication year - 2002
Publication title -
mycoses
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.13
H-Index - 69
eISSN - 1439-0507
pISSN - 0933-7407
DOI - 10.1046/j.1439-0507.2002.00744.x
Subject(s) - amphotericin b , medicine , gastroenterology , toxicity , pancreatitis , chemotherapy , pharmacology , liposome , acute pancreatitis , surgery , chemistry , antifungal , biochemistry , dermatology
Summary. Though liposomal amphotericin B has been available in Germany since 1992, efficacy and safety of this formulation of amphotericin B are still not well‐documented in children. As far as gastrointestinal side‐effects are concerned, an elevated alkaline phosphatase and elevated transaminases have been reported. In our department, liposomal amphotericin B had been used since 1994 to treat patients with proven or suspected fungal infections in a daily dose of 1–3 mg kg −1 . Additionally, patients with high‐dose chemotherapy and autologous stem cell support received liposomal amphotericin B prophylactically in a dose of 1 mg kg −1 three times per week. We performed a retrospective analysis of all 31 patients who had received liposomal amphotericin B by 1999. In five patients, an isolated transient elevation of the serum lipase level during, or shortly after, the therapy with liposomal amphotericin B was detected. Three of these patients showed clinical signs of pancreatitis, with one patient displaying slightly elevated transaminases. So far, elevated levels of serum lipase have not been described as a possible side‐effect of a liposomal amphotericin B therapy. The pathogenesis of this elevation is unclear. As possible reasons, an enzyme induction due to fat overload or a toxic damage of the pancreatic tissue by the liposomes or amphotericin B itself are discussed.