Nephrolithiasis associated with the use of topiramate in children

Yam, KM; Yau, Maggie; Fung, Eva

doi:10.12809/hkmj176908

Cited by 16 publications

(22 citation statements)

References 7 publications

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“…Klorokin katarakt oluşumuna neden olabilirken, hidroksiklorokin ile böyle bir etki saptanmamıştır. [18]…”

Section: Yan Etki Ve Toksisiteunclassified

“…Bu durum RPE hücrelerinde lipofusin artışına ve fotoreseptör yapısının bozulmasına neden olmaktadır. [18][19][20] Retinopatinin kesin mekanizması henüz aydınlatılamamıştır, ancak hayvan modellerinde, toksisitenin en erken histolojik kanıtı ganglion hücrelerinde gösterilmiştir, bunu diğer retina tabakaları (özellikle dış retina) ve RPE izler. RPE, tahrip olmuş fotoreseptörlerin bulunduğu bölgelere göç eder ve dış nükleer ve dış pleksiform tabakalarda pigment yüklü hücrelerin saptanmasına neden olur.…”

Section: Retinopati Gelişimiunclassified

“…RPE, tahrip olmuş fotoreseptörlerin bulunduğu bölgelere göç eder ve dış nükleer ve dış pleksiform tabakalarda pigment yüklü hücrelerin saptanmasına neden olur. [18] Retinopati gelişme riskini arttıran faktörler: hidrokiskloro-kin için günde 5 mg/kg'ı klorokin için ise 2,3 mg/kg'ı aşan ilaç dozu, ilacın uzun süreli kullanımı (10-25 yıl), yüksek kümülatif doz (600-1.000 g'ın üzeri), evre 3-5 kronik böbrek hastalığı ve 6 aydan uzun süreli tamoksifen tedavisidir. [20] Ülkemizden yapılan bir çalışmada ise; ilacın dozuna ve kullanım süresine bağlı olarak fundus otofloresans ve görme alanı testlerinde defekt gelişen hastaların analizinde, 425 gramın üzerinde kümülatif bir hidroksiklorokin dozunun, retinal toksisite riskini %91 duyarlılık ve %70 özgüllük ile artırdığı saptanmıştır.…”

Section: Retinopati Gelişimiunclassified

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Medications Damaging Retinal Pigment Epithelium and Photoreceptor Complex-1: Pathogenesis, Diagnosis, and Treatment (Chloroquine/hydroxychloroquine)

2023

Güncel Retina (Current Retina)

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Hydroxychloroquine and chloroquine are frequently used in the treatment of rheumatic and parasitic diseases as a result of their immunomodulatory effects. Due to their high plasma distribution volumes, they cause irreversible side effects by accumulating in the tissues containing melanin following long-term use. Currently, these side effects can be detected before they reach advanced stages (bull’s eye maculopathy) thanks to new developments in diagnosis and imaging methods. Patients with concomitant tamoxifen use, impaired renal function, a dose of hydroxychloroquine greater than 5mg per kg per day or the dose of chloroquine greater than 2,3 mg per kg per day, older age, long-term use (10-25 years) have increased risk of retinopathy. Patients should be reviewed annually thereafter whilst on therapy and they should undergo imaging with optical coherence tomography (OCT), widefield fundus autofluorescence imaging (FAF), and 10-2 visual field testing at each monitoring visit. If the evidence of toxicity cannot be completely excluded patients should undergo multifocal electroretinography (mfERG). Of the tests used in the diagnosis of hydroxychloroquine/chloroquine retinopathy, mfERG has the highest sensitivity and specificity, followed by SD-OCT and 10-2 visual field tests, respectively. Once the precise signs of early retinopathy are detected, the decision to stop the medication should be taken in conjunction with prescribing physician. It should not be forgotten that retinopathy findings will progress even if the treatment is ceased. Following the screening, guidelines allow early detection of retinopathy before leading to irreversible retinal damage.

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“…Klorokin katarakt oluşumuna neden olabilirken, hidroksiklorokin ile böyle bir etki saptanmamıştır. [18]…”

Section: Yan Etki Ve Toksisiteunclassified

Section: Retinopati Gelişimiunclassified

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Medications Damaging Retinal Pigment Epithelium and Photoreceptor Complex-1: Pathogenesis, Diagnosis, and Treatment (Chloroquine/hydroxychloroquine)

2023

Güncel Retina (Current Retina)

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“…Na Ásia, houve alguns relatos de caso de nefrolitíase em associação com o uso de TPM em crianças no Japão e na Coréia. Em Rochester, nos EUA, observou-se uma incidência de litíase de 36 por 100.000 pessoas-ano entre 2003 e 2008, e em Hong Kong um programa de triagem comunitário de 2008 em crianças expostas a produtos lácteos contaminados com melamina revelou uma prevalência de cálculo renal de 0,03% a 0,27%, embora essas crianças fossem saudáveis [15]. Dessa forma, é importante salientar que a ocorrência de litíase renal afeta indivíduos de diversas idades, gêneros e pode comprometer a qualidade de vida do paciente.…”

Section: Conclusãounclassified

A incidência de nefrolitíase em pacientes que fazem terapia com Topiramato: uma revisão de literatura/ The incidence of nephrolithiasis in patients undergoing Topiramat therapy: a literature review

Tonhon¹

2021

Braz. J. Hea. Rev.

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O objetivo desse trabalho é descrever a ocorrência de cálculos renais em indivíduos, especialmente portadores de epilepsia, que realizam tratamento com o fármaco denominado Topiramato, baseando-se em pesquisas nos bancos de dados PubMed e SciELO. Foram selecionados artigos classificados como mais antigos, publicados antes de 2010, e artigos considerados mais atuais, publicados após o ano de 2010, buscando determinada comparação com eles. As pesquisas demonstraram que, apesar de possuir uma baixa taxa de incidência, alguns pacientes que realizam terapia a longo prazo com o fármaco podem desenvolver litíase renal, comorbidade que gera grande impacto na qualidade de vida do indivíduo. Entretanto, na maioria dos casos relatados, a interrupção do tratamento com o medicamento proporcionou melhora no quadro e os cálculos renais desapareceram. Foi possível perceber também determinada incredulidade dos autores dos artigos mais antigos acerca da nefrolitíase, em que muitos não consideravam pertinente a relação entre a litíase renal e o uso do Topiramato. Em contrapartida, estudos atuais já enfatizaram a relação como algo significante.

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“…Thus, TPM has become one of the most frequently prescribed drugs in the USA, ranking among the top 50 most prescribed drugs [85]. TPM has been long known for its lithogenic effect through the metabolic changes induced by this drug [86][87][88][89][90][91][92][93]. A systematic review published in 2013 showed that the overall annual incidence of symptomatic nephrolithiasis with TPM usage was 2.1% [94]; however, the incidence of nephrolithiasis in the pediatric population ranged from 4.2% to 60% (Table 3).…”

Section: Topiramatementioning

confidence: 99%

Drug-Induced Urolithiasis in Pediatric Patients

et al. 2019

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Drug-induced nephrolithiasis is a rare condition in children. The involved drugs may be divided into two different categories according to the mechanism involved in calculi formation. The first one includes poorly soluble drugs that favor the crystallization and calculi formation. The second category includes drugs that enhance calculi formation through their metabolic effects. The diagnosis of these specific calculi depends on a detailed medical history, associated comorbidities and the patient's history of drug consumption. There are several risk factors associated with drug-induced stones, such as high dose of consumed drugs and long duration of treatment. Moreover, there are some specific risk factors, including urinary pH and the amount of fluid consumed by children. There are limited data regarding pediatric lithogenic drugs, and hence, our aim was to perform a comprehensive review of the literature to summarize these drugs and identify the possible mechanisms involved in calculi formation and discuss the management and preventive measures for these calculi.

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Nephrolithiasis associated with the use of topiramate in children

Cited by 16 publications

References 7 publications

Medications Damaging Retinal Pigment Epithelium and Photoreceptor Complex-1: Pathogenesis, Diagnosis, and Treatment (Chloroquine/hydroxychloroquine)

Medications Damaging Retinal Pigment Epithelium and Photoreceptor Complex-1: Pathogenesis, Diagnosis, and Treatment (Chloroquine/hydroxychloroquine)

A incidência de nefrolitíase em pacientes que fazem terapia com Topiramato: uma revisão de literatura/ The incidence of nephrolithiasis in patients undergoing Topiramat therapy: a literature review

Drug-Induced Urolithiasis in Pediatric Patients

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