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与两性霉素B治疗相关的可逆性扩张型心肌病。

Reversible dilated cardiomyopathy associated with amphotericin B therapy.

作者信息

Soares J R, Nunes M C P, Leite A F, Falqueto E B, Lacerda B E R A, Ferrari T C A

机构信息

Hospital das Clinicas of the Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.

出版信息

J Clin Pharm Ther. 2015 Jun;40(3):333-5. doi: 10.1111/jcpt.12237. Epub 2014 Dec 9.

Abstract

WHAT IS KNOWN AND OBJECTIVE

Amphotericin B (AmB) is commonly used to treat a broad spectrum of fungal infections and leishmaniasis. Its use is limited by numerous adverse effects. Reversible dilated cardiomyopathy associated with AmB is a rare disorder with only four previously reported cases, and all of them referring to patients who presented with a predisposing factor for heart failure.

CASE SUMMARY

A previously healthy 45-year-old man with visceral leishmaniasis treated with AmB developed acute dilated cardiomyopathy. Other causes of heart failure as well-known predisposing factors for this condition were ruled out. As with previously reported cases, the cardiac function of our patient returned to normal shortly after.

WHAT IS NEW AND CONCLUSION

We describe the first case of dilated cardiomyopathy associated with the administration of AmB in a patient without any known predisposing factor for developing cardiac dysfunction. Available evidence suggests that AmB may induce cardiotoxicity. Further investigations are needed to clarify this issue.

摘要

已知信息与目的

两性霉素B(AmB)常用于治疗多种真菌感染和利什曼病。其应用受到众多不良反应的限制。与AmB相关的可逆性扩张型心肌病是一种罕见疾病,此前仅报道过4例,且所有病例均涉及有心力衰竭易感因素的患者。

病例摘要

一名先前健康的45岁内脏利什曼病男性患者在接受AmB治疗后出现急性扩张型心肌病。排除了其他已知的心力衰竭病因以及该病症的易感因素。与先前报道的病例一样,我们这位患者的心脏功能在不久后恢复正常。

新发现与结论

我们描述了首例在无任何已知心脏功能障碍易感因素的患者中与AmB给药相关的扩张型心肌病病例。现有证据表明AmB可能诱发心脏毒性。需要进一步研究以阐明这一问题。

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