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Related Experiment Videos

Gentamicin nephropathy in a neonate.

K W Chan, W L Ng

    Pathology
    |July 1, 1985
    PubMed
    Summary
    This summary is machine-generated.

    Gentamicin therapy in premature infants can lead to acute renal failure and toxic serum levels. This study identifies unique kidney cell damage caused by gentamicin, previously unreported in neonates.

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    Area of Science:

    • Neonatal medicine
    • Nephrology
    • Toxicology

    Background:

    • Gentamicin is an antibiotic commonly used in neonatal intensive care units.
    • Penicillin is often co-administered with gentamicin for broad-spectrum coverage.
    • Premature infants are particularly vulnerable to drug toxicities due to immature organ systems.

    Observation:

    • A premature infant receiving gentamicin (5 mg/kg/day) and penicillin developed acute renal failure and anuria.
    • Toxic serum gentamicin concentrations were measured preceding the onset of anuria.
    • Autopsy revealed significant pathological changes in the neonatal kidneys.

    Findings:

    • Numerous periodic acid Schiff (PAS) positive, diastase-resistant cytoplasmic inclusions were identified in proximal convoluted tubules.

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  • Electron microscopy revealed these inclusions as myelin figures within cytosegresomes.
  • These specific pathological changes induced by gentamicin in human neonatal kidneys have not been previously documented.

    • Implications:

    • This case highlights the potential nephrotoxicity of gentamicin in premature neonates, even at standard doses.
    • The observed cellular changes provide a histopathological basis for gentamicin-induced kidney injury in this population.
    • Further research is warranted to monitor gentamicin levels and renal function closely in neonates to prevent adverse outcomes.