Hypokalemic rhabdomyolysis in a child due to amphotericin B therapy

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Paulo Sérgio Lucas da Silva1, Simone Brasil de Oliveira Iglesias, Jaques Waisberg

  • 1Pediatric Intensive Care Unit, Department of Pediatrics, Hospital do Servidor Público Municipal, São Paulo, Brazil. psls.nat@terra.com.br

European Journal of Pediatrics
|August 15, 2006
PubMed

Insights

Hypokalemia, a rare complication of amphotericin B, can cause rhabdomyolysis. Prompt treatment with potassium replacement is crucial for recovery from this potentially life-threatening condition.

Area of Science:

  • Pediatric Nephrology
  • Clinical Toxicology

Background:

  • Hypokalemia is a known adverse effect of amphotericin B treatment.
  • Rhabdomyolysis is a serious condition characterized by muscle breakdown.

Observation:

  • A pediatric case report detailing a 10-year-old boy experiencing lower extremity weakness, calf pain, and inability to walk after one week of amphotericin B therapy.
  • Initial laboratory findings revealed severe hypokalemia (serum potassium 1.7 mEq/L), elevated serum creatinine phosphokinase (3937 U/L), and myoglobulinuria.

Findings:

  • The case demonstrates a direct link between amphotericin B-induced hypokalemia and the development of rhabdomyolysis in a pediatric patient.
  • Successful treatment involved fluid expansion and intravenous potassium replacement, leading to complete resolution of muscular weakness within one week.

Implications:

  • Highlights hypokalemia as a rare but critical cause of rhabdomyolysis, particularly in pediatric patients receiving amphotericin B.
  • Emphasizes the importance of vigilant monitoring for hypokalemia and its potential complications in patients undergoing amphotericin B therapy.
  • Suggests the need for increased awareness and reporting of this rare adverse drug reaction in the pediatric literature.

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