Patey O, Dellion S, Halioua B, Lafaix C; International Conference on AIDS.
Int Conf AIDS. 1991 Jun 16-21; 7: 204 (abstract no. M.B.2091).
Departement des Maladies Infectieuses et Tropicales, Villeneuve St Georges, France
OBJECTIVE: To aware physicians of the potentiel danger of sulfonamide induced injury to the urinary tract. CASE REPORTS: We observed two cases of sulfadiazine crystalluria with transient renal failure in AIDS patients treated for toxoplasmic encephalitis (T.E.) with pyrimethamine (100 mg/day) and sulfadiazine (5 gr./day). They both developed hematuria, mild renal failure (serum level creatinine at 130 and 180 mumol/l. One had renal colic and abdominal ultrasound showed unilateral hydronephrosis. They recovered with forced diuresis and alkalinization of the urine. Sulfadiazine has been replaced with Dalacine. COMMENTS: The combination of sulfadiazine and Pyrimethamine is the treatment of choice for T.E. in AIDS patients. The mostly adverses effects are bone marrow suppression, fever and toxidermia. Renal toxicity is rarely reported but known since 1940. Sulfadiazine has a low urinary solubility, particularly in acidic urine. Crystallury can occur with local abrasion and chemical irritation of the epithelial cells of the kidney and urinary tract. Recommendation to prevent renal toxicity are an increase of drink, alkalinization of the urine with sodium bicarbonate and if necessary a change of therapy (clindamycine instead of sulfadiazine).
Publication Types:
Keywords:
- Acquired Immunodeficiency Syndrome
- Drug Therapy, Combination
- Encephalitis
- Hematuria
- Humans
- Hydronephrosis
- Kidney Failure, Acute
- Lithotripsy
- Pyrimethamine
- Sulfadiazine
- Urinary Calculi
- drug therapy
- therapy
Other ID:
UI: 102183013
From Meeting Abstracts