[在使用皮质激素和l -天冬酰胺酶治疗淋巴母细胞淋巴瘤期间继发于高甘油三酯血症的假低钠血症]。

IF 0.5 Q4 PEDIATRICS
Isabel Folatre, Mónica Kyonen, Daniela Schnettler, Mania Yilorm, Paula Monzón, Pilar Martínez, Gustavo Cea
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引用次数: 0

摘要

l -天冬酰胺酶(L-asp)是一种用于白血病和淋巴瘤治疗方案的抗肿瘤药物。据报道,10-50%接受L-Asp治疗的儿童脂质代谢发生改变。目的:报道与L-Asp应用相关的脂质代谢异常并发症。临床病例:我们描述了一个青少年的临床图片,在治疗淋巴母细胞非霍奇金淋巴瘤(NHL)期间,出现假性低钠血症和高甘油三酯血症,怀疑药物不良反应(ADR)。根据改进的因果关系算法(Karch和Lasagna)对这种怀疑进行了评估,得出l -天冬酰胺酶和皮质类固醇相关的“明确”不良反应。他接受了低脂饮食和降脂药物的治疗;l -天冬酰胺酶和强的松在方案结束后未暂停使用。治疗14天后,高甘油三酯血症恢复无并发症。结论:虽然高甘油三酯血症的严重程度并没有导致临床胰腺炎,但在鉴别诊断中应考虑到L-asp的不良反应怀疑,以强调发现这些并发症的必要性,并了解其预后和处理,以免影响患者的治疗。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[Pseudohiponatremia secondary to hypertriglyceridemia during the treatment of lymphoblastic lymphoma with corticoids and L-asparaginase].

L-asparaginase (L-asp) is an antineoplastic drug used in Leukemia and Lymphoma treatment protocols. Alterations in lipid metabolism have been reported in 10-50% of children treated with L-Asp.

Objective: To report an unusual complication of lipid metabolism associated with the use of L-Asp.

Clinical case: We describe the clinical picture of an adolescent who, during treatment for Lymphoblastic Non-Hodgkin Lymphoma (NHL), presented pseudohyponatremia and hypertriglyceridemia, suspecting an adverse drug reaction (ADR). This suspicion was evaluated according to the modified causality algorithm (Karch and Lasagna), resulting in a "definitive" ADR for the L-asparaginase and corticosteroids association. He received treatment with a low-fat diet and lipid-modifying drugs; L-asparaginase and prednisone were not suspended since the protocol ended. Hypertriglyceridemia recovered without complications after 14 days of treatment.

Conclusion: Although the magnitude of the hypertriglyceridemia did not result in clinical pancreatitis, it seems advisable to include ADR suspicion to L-asp among the differential diagnoses, to highlight the need to detect these complications, and to know their prognosis and management in order not to affect the treatment of the patients.

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