Co-trimoxazole-induced liver and renal failure

Windecker, Roland; Steffen, J.; Cascorbi, Ingolf; Thürmann, Petra A.

doi:10.1007/s002280050740

Cited by 17 publications

(6 citation statements)

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“…The findings for our case are compatible with those previously reported in that they showed high frequency of hepatic toxicity for the NAT2 slow acetylator genotype [7,12,16]. In view of the growing need for TMP-SMZ medication to prevent pneumocystis jiroveci pneumonia infection in collagen disease, further studies are required to investigate the relationship between NAT2 genotype and the adverse effects of TMP-SMZ.…”

Section: Discussionsupporting

confidence: 91%

“…Some studies have demonstrated the relationship between NAT2 genotype and NAT2 activity [12,13], in which the genotype without NAT2*4 is low in activity compared with the genotype carrying NAT2*4. The slow acetylator type, which is defined as the genotype without NAT2*4, is strongly connected with the adverse effect of TMP-SMZ; for example, 90% of patients complicated with hypersensitivity reactions to TMP-SMZ were identified as possessing the slow acetylator [7]. These findings imply that analysis for NAT2 genotype can be useful for prediction of adverse reactions to TMP-SMZ.…”

Section: Discussionmentioning

confidence: 94%

“…On the other hand, numerous cases of severe hepatic toxicity or fulminant hepatitis caused by TMP-SMZ have been reported [5][6][7][8][9], most of which were complicated by the use of TMP-SMZ as an anti-biotic drug for infectious disease. The mechanism of TMP-SMZ-induced hepatitis remains to be clarified [3], but several possibilities have been put forward.…”

Section: Discussionmentioning

confidence: 99%

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Trimethoprim-Sulfamethoxazole-Induced Hepatitis in Mixed Connective Tissue Disease

Sugimoto¹,

Nobuhara²,

Morinobu³

2011

IJCM

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 99%

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Trimethoprim-Sulfamethoxazole-Induced Hepatitis in Mixed Connective Tissue Disease

Sugimoto¹,

Nobuhara²,

Morinobu³

2011

IJCM

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“…Genetically susceptible individuals ‘fast acetylators’ may form these complexes at a higher rate leading to phospholipidosis (8). However, 90% of people who experience a hypersensitivity reaction are ‘slow acetylators’ (12). Liver failure with death associated with TMP–SMZ is rare.…”

Section: Discussionmentioning

confidence: 99%

Successful orthotopic liver transplantation after trimethoprim–sulfamethoxazole associated fulminant liver failure

Zaman¹,

Ye²,

Abreo³

et al. 2003

Clinical Transplantation

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Trimethoprim-sulfamethoxazole (TMP-SMZ) is one of the most commonly used antibiotics. Although many of its adverse effects are well recognized, TMP-SMZ related hepatotoxicity is considered rare and is usually characterized by cholestasis or mixed hepatocellular-holestatic reactions. In this study, we describe the case of a previously healthy young man with acute fulminant liver failure caused by TMP-SMZ. The patient presented with complaints of 'flu-like' symptoms with myalgia and fever after taking TMP-SMZ for 7 d for otitis externa. The patient subsequently developed fever, worsening jaundice, and a rash on his neck and chest. Liver enzymes peaked on day 3 with alanine aminotransferase (ALT) 11,549, aspartate aminotransferase (AST) 23,289, alkaline phosphatase 245, and total bilirubin 10.3 mg/dL, with a conjugated bilirubin of 8.3 mg/dL, prothrombin time (PT) 60.5 s, partial normalized ratio (PTT) 49 s, and international normalized ratio (INR) 7.5. Of note, acetaminophen level on admission was undetectable. Serology for hepatitis A, B, C, cytomegalovirus, HIV, toxoplasmosis, and blood cultures were all negative. The patient developed hepatic encephalopathy with hallucination on day 4. Laboratory tests revealed a serum ammonia level of 190 U, serum creatinine kinase (CK) 10,466 (42 on admission), serum creatinine 8.2 mg/dL (1.2 on admission), and significant metabolic acidosis. Renal ultrasound was unremarkable. The patient was started on hemodialysis for acute renal failure. Meanwhile, liver transplantation assessment was also initiated. On day 8 post-admission (15 d after taking TMP-SMZ), the patient received a successful orthotopic liver transplant.

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“…On the basis of sensitivity profile (Table 1), a regimen of trimethoprim-sulfamethoxazole (400 mg/80 mg q 8 hr) and tobramycin (1.7 mg/kg q 8 hr) was used. Because of deterioration of renal function, tobramycin was discontinued and trimethoprim-sulfamethoxazole was reduced (9,10). Because there was a history of transient ischemic attack, surgical replacement of the prosthetic valve was undergone on the 9th day after beginning of antibiotics.…”

Section: Two Episodes Of Stenotrophomonas Maltophilia Endocarditis Ofmentioning

confidence: 99%

Two Episodes of Stenotrophomonas maltophilia Endocarditis of Prosthetic Mitral Valve: Report of a Case and Review of the Literature

Kim

Kang

et al. 2002

J Korean Med Sci

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Stenotrophomonas maltophilia (previously named Xanthomonas maltophilia) is an aerobic, non-fermentive, Gram-negative bacillus that is wide spread in the environment. It was considered to be an organism with limited pathogenic potential, which was rarely capable of causing diseases in human other than those who were in debilitated or immunocompromised state. More recent studies have established that Stenotrophomonas maltophilia can behave as a true pathogen. Endocarditis due to this organism is rare, and only 24 cases of Stenotrophomonas maltophilia endocarditis have been reported in the medical literature. Most cases were associated with risk factors, including intravenous drug abuse, dental treatment, infected intravenous devices, and previous cardiac surgery. We present a case with two episodes of Stenotrophomonas maltophilia endocarditis after mitral valve prosthesis implantation, which was treated with antibiotics initially, and a combination of antibiotics and surgery later. To our knowledge, this is the first case of repetitive endocarditis due to Stenotrophomonas maltophilia.

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Co-trimoxazole-induced liver and renal failure

Cited by 17 publications

References 0 publications

Trimethoprim-Sulfamethoxazole-Induced Hepatitis in Mixed Connective Tissue Disease

Trimethoprim-Sulfamethoxazole-Induced Hepatitis in Mixed Connective Tissue Disease

Successful orthotopic liver transplantation after trimethoprim–sulfamethoxazole associated fulminant liver failure

Two Episodes of Stenotrophomonas maltophilia Endocarditis of Prosthetic Mitral Valve: Report of a Case and Review of the Literature

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