Unusual Complication of Multidrug Resistant Tuberculosis
Introduction. Capreomycin is a second-line drug often used for multidrug-resistant tuberculosis which can result in nephrotoxic effects similar to other aminoglycosides. We describe a case of capreomycin induced Bartter-like syndrome with hypocalcemic tetany. Case Report. 23-year-old female patient...
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Wiley
2017-01-01
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| Series: | Case Reports in Nephrology |
| Online Access: | http://dx.doi.org/10.1155/2017/6835813 |
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| author | Prerna Sharma Ravindra Nath Sahay |
| author_facet | Prerna Sharma Ravindra Nath Sahay |
| author_sort | Prerna Sharma |
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| description | Introduction. Capreomycin is a second-line drug often used for multidrug-resistant tuberculosis which can result in nephrotoxic effects similar to other aminoglycosides. We describe a case of capreomycin induced Bartter-like syndrome with hypocalcemic tetany. Case Report. 23-year-old female patient presented with carpopedal spasms and tingling sensations in hands. Patient was being treated with capreomycin for two months for tuberculosis. On further investigation, hypocalcemia, hyponatremia, hypomagnesemia, hypokalemia, and hypochloremic metabolic alkalosis were noted. Vitamin D and serum PTH levels were within normal limits. Hypercalciuria was confirmed by urine calcium/creatinine ratio. Calcium, potassium, and magnesium supplementation was given and capreomycin was discontinued. Electrolytes normalized in two days after cessation of capreomycin with no further abnormalities on repeat investigations. Discussion. Aminoglycosides can result in renal tubular dysfunction leading to Fanconi syndrome, Bartter syndrome, and distal tubular acidosis. Impaired mitochondrial function in the tubular cells has been hypothesized as the possible cause of these tubulopathies. Acquired Bartter-like syndrome phenotypically resembles autosomal dominant type 5 Bartter syndrome. Treatment consists of correction of electrolyte abnormalities, indomethacin, and potassium-sparing diuretics. Prompt diagnosis and treatment of severe dyselectrolytemia are warranted in patients on aminoglycoside therapy. |
| format | Article |
| id | doaj-art-ec38c4d97e744ae68ef935b687460e8b |
| institution | Kabale University |
| issn | 2090-6641 2090-665X |
| language | English |
| publishDate | 2017-01-01 |
| publisher | Wiley |
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| series | Case Reports in Nephrology |
| spelling | doaj-art-ec38c4d97e744ae68ef935b687460e8b2025-02-03T07:26:12ZengWileyCase Reports in Nephrology2090-66412090-665X2017-01-01201710.1155/2017/68358136835813Unusual Complication of Multidrug Resistant TuberculosisPrerna Sharma0Ravindra Nath Sahay1Division of Medicine, Seth G.S. Medical College & KEM Hospital, Parel, Mumbai 400 012, IndiaDivision of Medicine, Seth G.S. Medical College & KEM Hospital, Parel, Mumbai 400 012, IndiaIntroduction. Capreomycin is a second-line drug often used for multidrug-resistant tuberculosis which can result in nephrotoxic effects similar to other aminoglycosides. We describe a case of capreomycin induced Bartter-like syndrome with hypocalcemic tetany. Case Report. 23-year-old female patient presented with carpopedal spasms and tingling sensations in hands. Patient was being treated with capreomycin for two months for tuberculosis. On further investigation, hypocalcemia, hyponatremia, hypomagnesemia, hypokalemia, and hypochloremic metabolic alkalosis were noted. Vitamin D and serum PTH levels were within normal limits. Hypercalciuria was confirmed by urine calcium/creatinine ratio. Calcium, potassium, and magnesium supplementation was given and capreomycin was discontinued. Electrolytes normalized in two days after cessation of capreomycin with no further abnormalities on repeat investigations. Discussion. Aminoglycosides can result in renal tubular dysfunction leading to Fanconi syndrome, Bartter syndrome, and distal tubular acidosis. Impaired mitochondrial function in the tubular cells has been hypothesized as the possible cause of these tubulopathies. Acquired Bartter-like syndrome phenotypically resembles autosomal dominant type 5 Bartter syndrome. Treatment consists of correction of electrolyte abnormalities, indomethacin, and potassium-sparing diuretics. Prompt diagnosis and treatment of severe dyselectrolytemia are warranted in patients on aminoglycoside therapy.http://dx.doi.org/10.1155/2017/6835813 |
| spellingShingle | Prerna Sharma Ravindra Nath Sahay Unusual Complication of Multidrug Resistant Tuberculosis Case Reports in Nephrology |
| title | Unusual Complication of Multidrug Resistant Tuberculosis |
| title_full | Unusual Complication of Multidrug Resistant Tuberculosis |
| title_fullStr | Unusual Complication of Multidrug Resistant Tuberculosis |
| title_full_unstemmed | Unusual Complication of Multidrug Resistant Tuberculosis |
| title_short | Unusual Complication of Multidrug Resistant Tuberculosis |
| title_sort | unusual complication of multidrug resistant tuberculosis |
| url | http://dx.doi.org/10.1155/2017/6835813 |
| work_keys_str_mv | AT prernasharma unusualcomplicationofmultidrugresistanttuberculosis AT ravindranathsahay unusualcomplicationofmultidrugresistanttuberculosis |