HYPOGLYCEMIA AND DIABETES-MELLITUS FOLLOWING PARENTERAL PENTAMIDINE MESYLATE TREATMENT IN AIDS PATIENTS

被引:25
作者
PERRONNE, C [1 ]
BRICAIRE, F [1 ]
LEPORT, C [1 ]
ASSAN, D [1 ]
VILDE, JL [1 ]
ASSAN, R [1 ]
机构
[1] HOP BICHAT,DEPT DIABET,46 RUE HENRI HUCHARD,F-75877 PARIS 18,FRANCE
关键词
AIDS; Drug‐induced diabetes; Drug‐induced hypoglycaemia; Hypoglycaemia; Pentamidine;
D O I
10.1111/j.1464-5491.1990.tb01453.x
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Of 18 AIDS patients with Pneumocystis carinii pneumonia treated with pentamidine mesylate parenterally, four developed serious to severe hypoglycaemia, three hypoglycaemia followed by insulin‐requiring diabetes, and two others diabetes alone. Hypoglycaemia (blood glucose 2.1 ± 0.2 (±SE) mmol l−1) occurred 9 (2–22) days after starting treatment, and diabetes (initial blood glucose 30 ± 6 mmol l−1) after 60 (20–90) days. The other patients remained euglycaemic. The dysglycaemic patients (hypo‐ and hyper‐glycaemic) had a higher pentamidine dosage (p < 0.01), and higher serum creatinine levels at end of treatment (p < 0.001), consistent with drug accumulation and dose‐dependent toxicity. Plasma C‐peptide levels were low in the diabetic patients, in the basal state (0.25–0.28 nmol l−1) and following stimulation by IV glucagon (0.35–0.40 nmol l−1), vs 0.80 ± 0.06 nmol l−1 (basal) and 1.83 ± 0.16 nmol l−1 (stimulated) in 23 healthy control subjects (mean ± SE). Islet cell or insulin antibodies were not detected. Serum amylase levels rose abnormally in the dysglycaemic group, and pancreatitis was proved in one, and suspected in another patient. None of 28 similar AIDS patients whose P. carinii pneumonia was treated with cotrimoxazole showed blood glucose disturbance. 1990 Diabetes UK
引用
收藏
页码:585 / 589
页数:5
相关论文
共 48 条
[1]  
Wharton JM, Coleman DL, Wofsy CB, Et al., Trimethoprim‐sulfamethoxazole or pentamidine for Pneumocystis carinii pneumonia in the acquired immunodeficiency syndrome, Ann Intern Med, 105, pp. 37-44, (1986)
[2]  
Mills J., Pneumocystis carinii and Toxoplasma gondii infections in patients with AIDS, Rev Infect Dis, 8, pp. 1001-1011, (1986)
[3]  
Waskin H., Stehr-Green JK, Helmick CG, Sattler FR., Risk factors for hypoglycaemia associated with pentamidine therapy for pneumocystis pneumonia, J Am Med Assoc, 260, pp. 345-347, (1988)
[4]  
Waalkes TP, Denham C., de Vita VT., Pentamidine: clinical pharmacologic correlations in man and mice, Clin Pharmacol Ther, 11, pp. 505-512, (1970)
[5]  
Waalkes TP, Makulu DR., Pharmacologic aspects of pentamidine, pp. 171-178, (1976)
[6]  
Young RC, de Vita VT., Treatment of Pneumocystis carinii pneumonia: current status of the regimens of pentamidine isethionate and pyrimethamine‐sulfadiazine, Symposium on Pneumocystis carinii Infection, pp. 193-200, (1976)
[7]  
Cohn DL, Penley KA, Judson FN, Et al., The acquired immunodeficiency syndrome and a trimethoprim‐sulfamethazole adverse reaction (Letter), Ann Intern Med, 100, (1984)
[8]  
Gordin FM, Simon GW, Wofsy CB, Et al., Adverse reactions to trimethoprim‐sulfamethoxazole in patients with the acquired immunodeficiency syndrome, Ann Intern Med, 100, pp. 495-499, (1984)
[9]  
Bouchard, Sai P., Reach G., Caubarrerre I., Ganeval D., Assan R., Diabetes mellitus following pentamidine‐induced hypoglycemia in humans, Diabetes, 31, pp. 40-45, (1982)
[10]  
Broom WA., Toxicity and glycaemic properties of a number of amidine and guanidine derivatives, J Pharmacol Exp Ther, 57, pp. 81-97, (1936)