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Manifestaciones tóxicas cardiovasculares con el uso de antimoniales en una paciente con leishmaniasis cutánea / Cardiovascular toxic manifestations with the use of antimonials in a patient with cutaneous leishmaniasis / Manifestações tóxicas cardiovasculares com o uso de antimoniais em uma paciente com leishmanioses cutânea
Valverde, A; Berrouet, MC.
  • Valverde, A; Universidad CES. Medellín. CO
  • Berrouet, MC; Hospital General de Medellín. Medellín. CO
Med. U.P.B ; 38(1): 78-84, 13 de febrero de 2019. tab, Ilus
Article in Spanish | LILACS, COLNAL | ID: biblio-980306
RESUMEN
La toxicidad por antimoniales tiene múltiples manifestaciones sistémicas, entre ellas, las alteraciones cardiovasculares son de las de mayor gravedad, que pueden, incluso, llevar a la muerte. Reportamos el caso de una paciente anciana que durante el tratamiento con antimoniales para una leishmaniasis cutánea presentó toxicidad cardiaca y hepática con alteraciones electrolíticas como factor perpetuador de su condición clínica y con posterior desarrollo de múltiples episodios de taquicardia ventricular monomórfica y polimórfica. Durante el tratamiento recibió descargas sincrónicas y asincrónicas del desfibrilador, sobreestimulación con marcapasos y reposición de electrolitos, no se logró resolver del cuadro y la paciente falleció. Este reporte sobre la toxicidad de los antimoniales es importante porque están en la primera línea en el manejo de la leishmaniasis, a pesar de sus efectos sobre múltiples sistemas, por tanto, es necesario que los trabajadores de la salud se familiaricen con los signos y síntomas tempranos de su toxicidad.
ABSTRACT
Toxicity by antimonials has multiple systemic manifestations, including cardiovascular alteration, which is one of the most serious, as it can even lead to death of the patient. This article reports the case of an elderly patient who, during treatment with antimonials for cutaneous leishmaniasis, presented cardiac and hepatic toxicity associated with electrolyte imbalance as a perpetuating factor of her clinical condition, with subsequent development of multiple episodes of mono and polymorphic ventricular tachycardia. The patient was treated with synchronous and asynchronous defibrillation, overstimulation with pacemaker, and electrolyte replacement; she did not recover and eventually died. This report on the toxicity of antimonials is important as they remain the first-line treatment for leishmaniasis despite their multiple side effects, which can compromise multiple systems. Thus, health care professionals must become familiar with the early signs and symptoms of toxicity.
RESUMO
Toxicity by antimonials has multiple systemic manifestations, including cardiovascular alteration, which is one of the most serious, as it can even lead to death of the patient. This article reports the case of an elderly patient who, during treatment with antimonials for cutaneous leishmaniasis, presented cardiac and hepatic toxicity associated with electrolyte imbalance as a perpetuating factor of her clinical condition, with subsequent development of multiple episodes of mono and polymorphic ventricular tachycardia. The patient was treated with synchronous and asynchronous defibrillation, overstimulation with pacemaker, and electrolyte replacement; she did not recover and eventually died. This report on the toxicity of antimonials is important as they remain the first-line treatment for leishmaniasis despite their multiple side effects, which can compromise multiple systems. Thus, health care professionals must become familiar with the early signs and symptoms of toxicity.
Subject(s)


Full text: Available Index: LILACS (Americas) Main subject: Leishmania Limits: Humans Language: Spanish Journal: Med. U.P.B Journal subject: Medicine Year: 2019 Type: Article Affiliation country: Colombia Institution/Affiliation country: Hospital General de Medellín/CO / Universidad CES/CO

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Full text: Available Index: LILACS (Americas) Main subject: Leishmania Limits: Humans Language: Spanish Journal: Med. U.P.B Journal subject: Medicine Year: 2019 Type: Article Affiliation country: Colombia Institution/Affiliation country: Hospital General de Medellín/CO / Universidad CES/CO