2026-04-17T20:29:09Zhttps://recercat.cat/oai/request

oai:recercat.cat:11351/91562025-10-24T10:36:42Zcom_2072_378070com_2072_378040col_2072_378092

Persistent dyselectrolytemia in a neonate induced by liposomal amphotericin B: A case report Parramon Teixido, Carlos javier Hernández Pérez, Susana Frick, Marie Antoinette Cabañas Poy, Maria José Puertas Sanjuan, Adrian Institut Català de la Salut [Puertas Sanjuan A, Parramón-Teixidó CJ, Cabañas Poy MJ] Servei de Farmàcia, Vall d’Hebron Hospital Universitari, Barcelona, Spain. [Hernandez-Perez S] Servei de Neonatologia, Vall d’Hebron Hospital Universitari, Barcelona, Spain. [Frick MA] Unitat de Patologia Infecciosa i Immunodeficiències de Pediatria, Vall d’Hebron Hospital Universitari, Barcelona, Spain Vall d'Hebron Barcelona Hospital Campus Infants nadons Medicaments antifúngics - Ús terapèutic - Efectes secundaris NAMED GROUPS::Persons::Age Groups::Infant::Infant, Newborn CHEMICALS AND DRUGS::Chemical Actions and Uses::Pharmacologic Actions::Therapeutic Uses::Anti-Infective Agents::Antifungal Agents Other subheadings::Other subheadings::Other subheadings::/adverse effects DENOMINACIONES DE GRUPOS::personas::Grupos de Edad::lactante::recién nacido COMPUESTOS QUÍMICOS Y DROGAS::acciones y usos químicos::acciones farmacológicas::usos terapéuticos::antiinfecciosos::antifúngicos Otros calificadores::Otros calificadores::Otros calificadores::/efectos adversos Dyselectrolytemia; Neonate; Tubulopathy Diselectrolitemia; Neonato; Tubulopatía Diselectrolitèmia; Nounat; Tubulopatia Background: Nephrotoxicity is the most frequent serious adverse effect associated with amphotericin B deoxycholate treatment, for this reason, in recent years it has been relegated from routine clinical practice and replaced by the new liposomal formulations that have less nephrotoxicity. Nevertheless, dyselectrolytemia are a frequent adverse effect of the use of liposomal amphotericin B that usually are resolved with the withdrawal of the drug. Case presentation: We present a preterm neonate of 25 weeks gestation, with preserved renal function and most electrolytes within normal limits for gestational age except for mild hyponatremia in the first month of life. Due to an infection of the central nervous system and growth of Candida albicans, he required treatment with endovenous liposomal amphotericin B as well as intrathecal amphotericin B deoxycholate showing severe hydroelectrolyte disturbances and clinical worsening compatible with possible tubulopathy showing hypokalemia and severe hyponatremia a few days after starting treatment that persisted over time even after withdrawal of both drugs. Subsequently to the main alterations described, hypomagnesemia, hypophosphatemia, glycosuria and tubular proteinuria were also observed. Calcium levels remained stable after amphotericin B administration and did not require supplementation. In preterm or low birth weight newborns who present unjustified, severe and difficult to correct hydroelectrolyte disturbances despite the usual treatment, a possible tubulopathy should be considered, whether hereditary, primary or secondary to toxins or drugs. What is new and conclusion: We present the first case reported in a neonate in whom dyselectrolithemia has been maintained over time after withdrawal of liposomal amphotericin B. 2023-03-13T08:56:53Z 2023-03-13T08:56:53Z 2023-01-10 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion Puertas Sanjuan A, Parramón-Teixidó CJ, Hernandez-Perez S, Frick MA, Cabañas Poy MJ. Persistent dyselectrolytemia in a neonate induced by liposomal amphotericin B: A case report. Front Pediatr. 2023 Jan 10;10:1099305. 2296-2360 https://hdl.handle.net/11351/9156 10.3389/fped.2022.1099305 36704126 000921851900001 http://hdl.handle.net/11351/9156 eng Frontiers in Pediatrics;10 https://doi.org/10.3389/fped.2022.1099305 Attribution 4.0 International http://creativecommons.org/licenses/by/4.0/ info:eu-repo/semantics/openAccess application/pdf Frontiers Media Scientia