Document Detail


Acute refractory hyperkalaemia and fatal cardiac arrest related to administration of liposomal amphotericin B.
MedLine Citation:
PMID:  19011270     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
A 36-year-old male with acute myeloid leukaemia was treated with liposomal amphotericin B for a breakthrough fungal infection with Absidia corymbifera during voriconazole and caspofungin therapy for invasive pulmonary aspergillosis. Four episodes of hyperkalaemia developed with a highly probable relation to infusion of liposomal amphotericin B, of which the last episode was characterised by severe, refractory hyperkalaemia and fatal cardiac arrest. The available literature on severe hyperkalaemia and cardiac arrest during administration of both conventional and liposomal amphotericin B is reviewed here and revealed only four similar cases. The most likely mechanism of toxicity is the release of potassium from a variety of mammal cells including erythrocytes and endothelial cells. Whether prevention of toxicity can be established by decreasing the infusion rate is unclear but conceivable.
Authors:
O A Groot; R J Trof; A R Girbes; N L Swart; A Beishuizen
Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  The Netherlands journal of medicine     Volume:  66     ISSN:  0300-2977     ISO Abbreviation:  Neth J Med     Publication Date:  2008 Nov 
Date Detail:
Created Date:  2008-11-17     Completed Date:  2009-01-13     Revised Date:  2009-11-19    
Medline Journal Info:
Nlm Unique ID:  0356133     Medline TA:  Neth J Med     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  433-7     Citation Subset:  IM    
Affiliation:
Department of Intensive Care and Clinical Pharmacology, VU Medical Center, Amsterdam, the Netherlands.
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MeSH Terms
Descriptor/Qualifier:
Absidia / isolation & purification
Adult
Amphotericin B / adverse effects*,  therapeutic use
Antifungal Agents / adverse effects*,  therapeutic use
Fatal Outcome
Heart Arrest / chemically induced*
Humans
Hyperkalemia / chemically induced*
Leukemia, Myeloid, Acute / drug therapy,  microbiology
Male
Mucormycosis / drug therapy
Chemical
Reg. No./Substance:
0/Antifungal Agents; 1397-89-3/Amphotericin B

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