Objective: To describe a retrospective study of six HIV-positive individuals with compensated metabolic acidosis while receiving intravenous trimethoprim/sulfamethoxazole (TMP/SMX).
Case Summary: Six HIV-infected patients were treated for Pneumocystis carinii pneumonia (PCP) with high-dose intravenous TMP/SMX. In spite of a favorable clinical and radiologic course, all six patients developed compensated metabolic acidosis 3-5 days after the start of treatment. This potential complication of TMP/SMX use was successfully managed with conservative treatment (cessation of therapy with or without additional administration of intravenous bicarbonate).
Discussion: TMP/SMX is first-line therapy for PCP in HIV-positive individuals, despite a high frequency of toxic effects in these patients. In addition to the cases reported here, only two other reports of metabolic acidosis secondary to TMP/SMX use in HIV-infected patients have been published in the literature. The precise mechanism of this untoward effect is not fully understood, although renal tubular acidosis induced by TMP/SMX could be implicated.
Conclusions: TMP/SMX toxicity should be considered in the differential diagnosis of HIV-infected patients with acute metabolic acidosis. Metabolic acidosis can be expected to resolve shortly after discontinuation of the drug.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1345/aph.17042 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Use of Hemoadsorption and Continuous Venovenous Hemodialysis With Enhanced Middle Molecule Clearance in Drug-Induced Rhabdomyolysis.
Case Rep Crit Care
January 2025
Department of Anesthesiology and Intensive Care Medicine, Kreiskliniken Günzburg-Krumbach, Krumbach, Germany.
Drug-induced rhabdomyolysis has become increasingly prevalent due to the rising use of medications such as statins, antidepressants, and antipsychotics. These can lead to muscle cell destruction and the release of myoglobin, potentially causing kidney damage. Recent advancements include the use of CytoSorb hemoadsorption as a promising therapy to remove myoglobin and other potentially toxic substances from the bloodstream.
View Article and Find Full Text PDFOn the substrate turnover rate of NBCe1 and AE1 SLC4 transporters: structure-function considerations.
Front Physiol
January 2025
Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States.
A transport protein's turnover rate (TOR) is the maximum rate of substrate translocation under saturating conditions. This parameter represents the number of transporting events per transporter molecule (assuming a single transport site) per second (s). From this standpoint, a transporter's TOR is similar to an enzyme's catalytic constant.
View Article and Find Full Text PDFA Rare Clinical Confluence: Metachromatic Leukodystrophy and Distal Renal Tubular Acidosis.
Indian J Nephrol
August 2024
Department of Pediatrics, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India.
Retrospective evaluation of patients admitted to the intensive care unit due to obstetric reasons in terms of maternal near-miss, a five-year case-control study.
BMC Pregnancy Childbirth
January 2025
İzmir Bozyaka Training and Research Hospital, Department of Family Medicine, Health Sciences University, İzmir, Turkey.
Background: Maternal Near-Miss (MNM) has become globally recognized as an indicator of pregnancy, birth and the first 42 days of postpartum care services. The World Health Organization has taken a new approach to detail and better analyze maternal deaths. The clinic-based criteria to evaluate maternal care and the quality of related care services have been developed.
View Article and Find Full Text PDFExocrine pancreatic insufficiency as an unusual extrarenal manifestation of proximal renal tubular acidosis associated with a novel SLC4A4 mutation.
Pediatr Nephrol
January 2025
Department of Pediatric Nephrology, Istanbul University- Cerrahpasa, Cerrahpasa Faculty of Medicine, 34098, Istanbul, Turkey.
Autosomal recessive proximal renal tubular acidosis (AR-pRTA) with ocular abnormalities is a rare syndrome caused by variants in the SLC4A4 gene, which encodes Na/HCO3 cotransporter (NBCe1). The syndrome primarily affects the kidneys, but also causes extra-renal manifestations. Pancreatic type NBCe1 is located at the basolateral membrane of the pancreatic ductal cells and together with CFTR chloride channel, it is involved in bicarbonate secretion.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!