Zernikow B, Fleischack G, Hasan C, Bode U
Abteilung Pädiatrische Hämatologie/Onkologie, Universitätskinderkinik.
Klin Padiatr. 1996 Mar-Apr;208(2):53-5. doi: 10.1055/s-2008-1043994.
Despite its wellknown adverse effects, Amphoterin B is an integral part of any supportive therapy in haematology/oncology. We report on a thirteen year old boy with acute myelogenous leukemia and suspected fungoid pneumonia. Shortly after iv or inhalative application of Amphotericin B he repeatedly presented with a Raynaud phenomenon of his toes, which ceased after switching to Ambisome (liposomal unilamellar encapsuled Amphotericin B). Since there is evidence that thromboxane A2-mediated arteriolar spasms of renal vessels provoke the wellknown increase in serum creatinine after Amphotericin B, and in different species pulmonal vasoconstriction has been observed, we speculate that a similar mechanism is responsible for the observed Raynaud phenomenon. Thus we suggest inhibitors of prostaglandine synthesis for therapy.
尽管两性霉素B有众所周知的不良反应，但它仍是血液学/肿瘤学任何支持性治疗中不可或缺的一部分。我们报告了一名13岁患急性髓性白血病且疑似真菌性肺炎的男孩。在静脉注射或吸入两性霉素B后不久，他的脚趾反复出现雷诺现象，改用安必素（脂质体单层包裹的两性霉素B）后该现象消失。由于有证据表明血栓素A2介导的肾血管小动脉痉挛会导致两性霉素B使用后血清肌酐升高，并且在不同物种中已观察到肺血管收缩，我们推测类似机制导致了观察到的雷诺现象。因此，我们建议使用前列腺素合成抑制剂进行治疗。
