Nephrotoxicity Attributed to Meglumine Antimoniate (Glucantime) in the Treatment of Generalized Cutaneous Leishmaniasis

Abstract

The treatment with Glucantime was responsible by ARF diagnosed in this patient. The previous urine osmolarity and serum creatinine levels were normal and the autopsy showed ATN. It should be pointed out if ARF may also be explained by massive deposits of immunocomplexes by leishmania antibodies and antigens due to the antigenic break by the antimonial compound, since our patient presented countless lesions covering the entire tegument, similar to the Hexheimer phenomenon, but at the autopsy no glomerular alterations were seen.

Renal function evaluation in patients with American Cutaneous Leishmaniasis after specific treatment with pentavalent antimonial

“…Previous reports on the renal involvement in ACL have linked renal abnormalities to the use of these drugs, as acute kidney injury by tubulointerstitial nephritis or reaction Jarish-Herxheimer like, which is not in accordance to our findings [12,15]. …”

“…In ACL there are very few studies regarding renal function evaluation, and the renal abnormalities described are linked to specific treatment with pentavalent antimonials [15]. These drugs are described to cause acute kidney injury due to hypersensitivity reaction [12].…”

Drug reaction with eosinophilia and systemic symptoms (DRESS) and multiple organ dysfunction syndrome (MODS): one more reason for a new effective treatment against leishmaniasis

“…As for visceral involvement, the liver is the most frequently compromised in both conditions leading to acute hepatitis or liver necrosis and death. High levels of transaminases and alkaline phosphatase can persist elevated even after months of drug exposure , , …”

Administration of Miltefosine and Meglumine Antimoniate in Healthy Dogs: Clinicopathological Evaluation of the Impact on the Kidneys

“…6, 2009 MILTEFOSINE AND GLUCANTIME IN DOGSMonitoring of Sb urinary excretion indicates that the kidneys are the almost exclusive route of elimination of meglumine antimoniate (Hantson et al 2000); however, no specific guidelines exist for dosage adjustment in renal failure. Even if nephrotoxicity has rarely been related to this treatment in humans, some cases of acute renal failure as a result of acute tubular necrosis, followed by death after receiving Glucantime, have been reported in human patients (Rodrigues et al 1999).…”