Liposomal amphotericin B was successfully used to treat a case of kala-azar with prominent renal damage
10.3760/cma.j.cn231583-20210801-00245
- VernacularTitle:两性霉素B脂质体成功治疗1例以肾损害为突出表现的黑热病
- Author:
Pei JIA
1
;
Xiaojing LIU
;
Wanhu FAN
;
He QIU
;
Yao WANG
;
Wenya CAO
;
Danfeng REN
Author Information
1. 西安交通大学第一附属医院感染性疾病科，西安 710000
- Keywords:
Kala-azar;
Renal damage;
Liposomal amphotericin B;
Treatment
- From:
Chinese Journal of Endemiology
2022;41(9):761-765
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the diagnosis and treatment process of a kala-azar case with prominent renal damage treated with liposomal amphotericin B (L-AmB), and to provide theoretical basis for clinical diagnosis and treatment.Methods:A retrospective analysis method was used to analyze the clinical data, diagnosis and treatment process and laboratory test results of a case of kala-azar with prominent renal damage who presented to the Department of Infectious Diseases, The First Affiliated Hospital of Xi'an Jiaotong University on June 30, 2020.Results:A 56-year-old female patient presented with fever (the highest body temperature was 38.2 ℃) and chills. The results of clinical laboratory tests showed that hemoglobin(55 g/L), red blood cell (2.68 × 10 12/L), white blood cell (1.06 × 10 9/L) and platelet count (8.00 × 10 9/L) were decreased, renal function showed abnormal blood urea nitrogen and creatinine, spleen enlargement, etc., and the diagnosis of kala-azar combined with kidney insufficiency was confirmed by blood and bone marrow Leishmania spp. examination. With the assistance of continuous renal replacement therapy (CRRT), after a small dose of L-AmB was initially and slowly increased and maintained at a low dose, the patient's body temperature was normal, the blood routine showed that the three-lineage cells gradually increased, and the renal function showed blood urea nitrogen and creatinine decreased gradually the spleen was retracted; no recurrence was found at follow-up after 6 months, and renal function returned to normal. Conclusions:L-AmB is safe and effective in the treatment of kala-azar with renal damage as the prominent manifestation. The patient is not only cured by etiology, but is also recovered renal function.
