Keating M J, Sethi M R, Bodey G P, Samaan N A
Cancer. 1977 Apr;39(4):1410-4. doi: 10.1002/1097-0142(197704)39:4<1410::aid-cncr2820390409>3.0.co;2-d.
Seventeen patients with malignant disease developed a complex metabolic syndrome of 2-8 weeks' duration characterized by hypocalcemia, hypomagnesemia and hypokalemia following administration of the aminoglycoside group of antibiotics. Gentamicin, Tobramycin, Amikacin, and Sisomicin were all involved. Other features noted were hypoalbuminemia, hypophosphatemia, and hypouricemia. Low immunoreactive parathyroid hormone (i-PTH) levels in the presence of hypocalcemia and absence of hyperplastic changes in the parathyroid gland examined at postmortem confirmed a diagnosis of hypoparathyroidism. Immunoreactive calcitonin levels (i-CT) were not elevated. Renal tubular wasting of potassium and magnesium was documented in six patients and excessive urinary loss of sodium, phosphate, and uric acid was noticed. Twelve patients died before recovering from the metabolic stress and five patients developed progressive renal impairment. A possible potentiating action of chemotherapeutic agents, especially Adriamycin, is suggested.
17例恶性疾病患者在使用氨基糖苷类抗生素后出现了持续2 - 8周的复杂代谢综合征，其特征为低钙血症、低镁血症和低钾血症。庆大霉素、妥布霉素、阿米卡星和西索米星均有涉及。其他观察到的特征包括低白蛋白血症、低磷血症和低尿酸血症。尸检时发现甲状旁腺无增生性改变，同时伴有低钙血症时免疫反应性甲状旁腺激素（i - PTH）水平降低，证实了甲状旁腺功能减退的诊断。免疫反应性降钙素水平（i - CT）未升高。6例患者记录有肾小管钾和镁流失，同时发现钠、磷酸盐和尿酸尿排泄过多。12例患者在代谢应激恢复前死亡，5例患者出现进行性肾功能损害。提示化疗药物尤其是阿霉素可能有增强作用。
