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Amphotericin B lipid complex (ABLC)-associated hypertension: case report and review
1Department of Infectious Diseases, Wilford Hall Medical Center, Lackland Air Force Base, OH 45433, USA. David.Rowles@wpafb.af.mil
Abstract:
Amphotericin B (AmB) continues to be the mainstay of therapy for serious fungal infections, despite its relatively toxic side-effect profile. Lipid preparations of the medication have been marketed in the past few years in an attempt to reduce some of these side effects, especially nephrotoxicity. Although 6 cases of severe hypertension associated with the use of AmB deoxycholate have been reported in the literature, no cases of hypertension associated with a lipid-containing preparation of the medication have been reported. We report here the first case of severe hypertension associated with the infusion of AmB lipid complex (ABLC) in a patient with multiple intraperitoneal and urinary fungal pathogens. We also provide a brief review of the previously reported cases of hypertension associated with the deoxycholate formulation of AmB.
Insights
Severe hypertension is a rare side effect of Amphotericin B (AmB). This report details the first case of severe hypertension linked to Amphotericin B lipid complex (ABLC), a lipid formulation, in a patient with serious fungal infections.
Area of Science:
- Mycology
- Pharmacology
- Nephrology
Background:
- Amphotericin B (AmB) is a critical antifungal agent for severe infections.
- Lipid formulations of AmB aim to mitigate side effects like nephrotoxicity.
- Hypertension is a known, albeit rare, side effect of AmB deoxycholate.
Observation:
- This study reports the first documented case of severe hypertension associated with Amphotericin B lipid complex (ABLC).
- The patient presented with multiple intraperitoneal and urinary fungal pathogens.
- The hypertension occurred during the infusion of ABLC.
Findings:
- Severe hypertension is a potential adverse effect of Amphotericin B lipid complex (ABLC).
- This contrasts with the absence of reported hypertension cases for lipid formulations previously.
- A review of hypertension cases linked to AmB deoxycholate is provided.
Implications:
- Clinicians should monitor for severe hypertension in patients receiving ABLC, especially those with significant fungal burdens.
- This finding may necessitate revised monitoring protocols for ABLC infusions.
- Further research into the mechanisms and incidence of ABLC-induced hypertension is warranted.