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Pancreatic toxicity after liposomal amphotericin B.

A Stuecklin-Utsch1, C Hasan, U Bode

  • 1Department of Pediatric Haematology-Oncology, University of Bonn, Germany. fleischh@mailer.meb.uni-bonn.de

Mycoses
|July 9, 2002
PubMed
Summary
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Liposomal amphotericin B, used for fungal infections in children, may cause elevated serum lipase levels. This potential side effect, possibly linked to pancreatitis, requires further investigation into its cause.

Area of Science:

  • Pediatric Infectious Diseases
  • Pharmacology
  • Gastroenterology

Background:

  • Liposomal amphotericin B (LAB) is available in Germany but its pediatric safety and efficacy are not well-documented.
  • Gastrointestinal side effects like elevated alkaline phosphatase and transaminases have been reported.
  • LAB is used for treating and preventing fungal infections in pediatric patients, including those undergoing chemotherapy.

Purpose of the Study:

  • To investigate the safety profile of liposomal amphotericin B in pediatric patients.
  • To identify and document potential adverse effects of LAB therapy in children.
  • To assess the incidence of elevated serum lipase levels and pancreatitis associated with LAB treatment.

Main Methods:

  • Retrospective analysis of 31 pediatric patients treated with liposomal amphotericin B between 1994 and 1999.

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  • Dose regimens included 1-3 mg/kg/day for treatment and 1 mg/kg three times weekly for prophylaxis.
  • Monitoring for adverse events, including gastrointestinal side effects and serum lipase levels.

    • Main Results:

    • Five patients experienced isolated, transient elevations in serum lipase levels during or shortly after LAB therapy.
    • Three of these patients exhibited clinical signs of pancreatitis.
    • One patient with pancreatitis also showed slightly elevated transaminases.

    Conclusions:

    • Elevated serum lipase levels may be an unreported side effect of liposomal amphotericin B in children.
    • The pathogenesis of lipase elevation is unclear, with potential causes including enzyme induction or direct toxicity.
    • Further research is needed to elucidate the mechanism and clinical significance of this finding.