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Amphotericin B-induced nephrogenic diabetes insipidus in a case of cryptococcemia

Yukio Fujita1, Kei Kasahara, Kenji Uno

  • 1Second Department of Internal Medicine, Nara Medical University, Japan.

Internal Medicine (Tokyo, Japan)
|June 9, 2005
PubMed

Insights

Amphotericin B treatment for cryptococcemia can cause nephrogenic diabetes insipidus, leading to hypokalemia and polyuria. Prompt fluid and potassium replacement can manage this reversible side effect, allowing treatment completion.

Area of Science:

  • Nephrology
  • Infectious Diseases
  • Oncology

Background:

  • Malignant lymphoma patients undergoing chemotherapy are susceptible to opportunistic infections like cryptococcemia.
  • Amphotericin B is a critical antifungal agent for treating invasive fungal infections.

Observation:

  • A 66-year-old woman developed neutropenia and cryptococcemia during chemotherapy.
  • Following amphotericin B initiation, she experienced significant polyuria and hypokalemia with stable renal function.
  • No evidence of renal tubular acidosis was detected.

Findings:

  • The patient was diagnosed with amphotericin B-induced nephrogenic diabetes insipidus, characterized by hypokalemia and polyuria.
  • Renal function remained stable throughout the course.
  • Discontinuation of amphotericin B led to prompt resolution of polyuria and hypokalemia.

Implications:

  • Amphotericin B can induce reversible nephrogenic diabetes insipidus, a notable side effect.
  • Vigorous water and potassium management are crucial for tolerating amphotericin B therapy.
  • Close monitoring of fluid balance and renal function is essential during treatment.

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