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。
[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.