Hostname: page-component-cd9895bd7-hc48f Total loading time: 0 Render date: 2024-12-28T01:12:05.849Z Has data issue: false hasContentIssue false
  • English
  • Français

Risk factors associated with dizziness during treatment of mucosal leishmaniasis with meglumine antimoniate: 16-year retrospective study of cases from Rio de Janeiro, Brazil

Published online by Cambridge University Press:  11 June 2010

M H Araujo-Melo ,
A M Meneses ,
A O Schubach ,
J S Moreira ,
F Conceição-Silva ,
M M Salgueiro ,
M I F Pimentel ,
M Araújo-Silva ,
R V C Oliveira  and
C N Carmo
...Show all authors
M H Araujo-Melo*
Affiliation:
Laboratory Surveillance Leishmaniasis, Evandro Chagas Clinical Research Institute, Brazil
A M Meneses
Affiliation:
Department of the Army, Central Hospital of Rio de Janeiro, Brazil
A O Schubach
Affiliation:
Laboratory Surveillance Leishmaniasis, Evandro Chagas Clinical Research Institute, Brazil
J S Moreira
Affiliation:
Laboratory Surveillance Leishmaniasis, Evandro Chagas Clinical Research Institute, Brazil
F Conceição-Silva
Affiliation:
Department of Immunology, Oswaldo Cruz Institute, Brazil
M M Salgueiro
Affiliation:
Laboratory Surveillance Leishmaniasis, Evandro Chagas Clinical Research Institute, Brazil
M I F Pimentel
Affiliation:
Laboratory Surveillance Leishmaniasis, Evandro Chagas Clinical Research Institute, Brazil
M Araújo-Silva
Affiliation:
Laboratory Surveillance Leishmaniasis, Evandro Chagas Clinical Research Institute, Brazil
R V C Oliveira
Affiliation:
Laboratory of Clinical Epidemiology, Evandro Chagas Clinical Research Institute (IPECFIOCRUZ), Brazil
C N Carmo
Affiliation:
Department of Endemy Samuel Pessoa, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
C M Valete-Rosalino
Affiliation:
Laboratory Surveillance Leishmaniasis, Evandro Chagas Clinical Research Institute, Brazil
*
Address for correspondence: Dr Maria Helena de Araujo-Melo, Rua Conde de Bonfim, 383 Apto 202, Tijuca, Rio de Janeiro, Brazil, CEP 20 520-051. Fax:  + 55 2132832669 E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

To evaluate dizziness in patients receiving meglumine antimoniate for the treatment of mucosal leishmaniasis.

Materials and methods:

We retrospectively studied 127 patients treated at the Laboratory of Leishmaniasis Surveillance, Evandro Chagas Clinical Research Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil, between 1 January 1989 and 31 December 2004.

Results:

A low dose of meglumine antimoniate (5 mg/kg/day) was used in 86.6 per cent of patients; a dose of 10 mg/kg/day or higher was used in 13.4 per cent of patients. Dizziness was reported by 4.7 per cent of patients. The adjusted odds ratios were 7.37 for dizziness in female patients, 4.9 for dizziness in patients aged 60 years or older, and 7.77 for dizziness in the presence of elevated serum lipase.

Conclusion:

We suggest that dizziness may be a side effect of meglumine antimoniate, particularly in elderly individuals, in females and in patients with elevated serum lipase.

Keywords

LeishmaniasisMeglumine AntimoniateDizzinessOtotoxicity
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 124 , Issue 10 , October 2010 , pp. 1056 - 1060
Copyright
Copyright © JLO (1984) Limited 2010

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1Goodwin, LG. Pentostam (sodium stibogluconate); a 50-year personal reminiscence [Historical Article]. Trans R Soc Trop Med Hyg 1995;89:339–41CrossRefGoogle ScholarPubMed
2Di Lella, F, Vicenti, V, Zennaro, D, Afeltra, A, Baldi, A, Giordano, D et al. Mucocutaneous leishmaniasis: report of a case with massive involvement of nasal, pharyngeal and laryngeal mucosa. Int J Oral Maxillofac Surg 2006;35:870–2CrossRefGoogle ScholarPubMed
3Amato, VS, Tuon, FF, Bacha, HA, Neto, VA, Nicodemo, AC. Mucosal leishmaniasis: current scenario and prospects for treatment. Acta Trop 2008;105:1–9CrossRefGoogle ScholarPubMed
4Vianna, G. About the treatment of cutaneous leishmaniasis [in Portuguese]. An. Paul Med Cir 1914;2:167–9Google Scholar
5Berman, JD. Chemotherapy for leishmaniasis: biochemical mechanisms, clinical efficacy, and future strategies. Rev Infect Dis 1988;10:560–86CrossRefGoogle ScholarPubMed
6Herwaldt, BL, Berman, JD. Recommendations for treating leishmaniasis with sodium stibogluconate (Pentostam) and review of pertinent clinical studies. Am J Trop Med Hyg 1992;46:296–306CrossRefGoogle ScholarPubMed
7Azeredo-Coutinho, RB, Mendonca, SC. An intermittent schedule is better than continuous regimen of antimonial therapy for cutaneous leishmaniasis in the municipality of Rio de Janeiro, Brazil. Rev Soc Bras Med Trop 2002;35:477–81CrossRefGoogle ScholarPubMed
8Azeredo-Coutinho, RB, Mendonca, SC, Callahan, H, Portal, AC, Max, G. Sensitivity of Leishmania braziliensis promastigotes to meglumine antimoniate (Glucantime) is higher than that of other Leishmania species and correlates with response to therapy in American tegumentary leishmaniasis. J Parasitol 2007;93:688–93CrossRefGoogle ScholarPubMed
9Ministério da Saúde. Manual Monitoring of Cutaneous Leishmaniasis [in Portuguese]. Brazil: Fundação Nacional de Saúde, 2007Google Scholar
10Oliveira-Neto, MP, Schubach, A, Araujo, ML, Pirmez, C. High and low doses of antimony (Sbv) in American cutaneous leishmaniasis. A five years follow-up study of 15 patients. Mem Inst Oswaldo Cruz 1996;91:207–9CrossRefGoogle ScholarPubMed
11Oliveira-Neto, MP, Schubach, A, Mattos, M, Goncalves-Costa, SC, Pirmez, C. A low-dose antimony treatment in 159 patients with American cutaneous leishmaniasis: extensive follow-up studies (up to 10 years). Am J Trop Med Hyg 1997;57:651–5CrossRefGoogle ScholarPubMed
12Oliveira-Neto, MP, Schubach, A, Mattos, M, Goncalves-Costa, SC, Pirmez, C. Treatment of American cutaneous leishmaniasis: a comparison between low dosage (5 mg/kg/day) and high dosage (20 mg/kg/day) antimony regimens. Pathol Biol (Paris) 1997:45:496–9Google ScholarPubMed
13Oliveira-Neto, MP, Mattos, M, Pirmez, C, Fernandes, O, Goncalves-Costa, SC, Souza, CF et al. Mucosal leishmaniasis (“espundia”) responsive to low dose of N-methyl glucamine (Glucantime) in Rio de Janeiro, Brazil. Rev Inst Med Trop Sao Paulo 2000;42:321–5CrossRefGoogle Scholar
14Schubach, A, Miekeley, N, Mortari, SR, Moreira, JS, Conceição-Silva, F, Salgueiro, MM et al. Studies on the metabolism of antimony and its species in the treatment of cutaneous leishmaniasis with low doses of antimonials [in Portuguese]. Int Rev Soc Bras Med Trop 2002;35:102–3Google Scholar
15Schubach, AO, Marzochi, KBF, Moreira, JS, Schubach, TMP, Araújo, ML, Francesconi-do-Vale, AC et al. Retrospective study of 151 patients with cutaneous leishmaniasis treated with meglumine antimoniate. Int Rev Soc Bras Med Trop 2005;38:213–17CrossRefGoogle ScholarPubMed
16Cuce, LC, Belda, W Jr, Dias, MC. Renal changes caused by pentavalent antimonial (Glucantime) hypersensitivity in American tegumentary leishmaniasis. Rev Inst Med Trop Sao Paulo 1990;32:249–51Google ScholarPubMed
17Gasser, RA, Magill, AJ, Oster, CN, Franke, ED, Grogl, M, Berman, JD. Pancreatitis induced by pentavalent antimonial agents during treatment of leishmaniasis. Clin Infect Dis 1994;18:83–90CrossRefGoogle ScholarPubMed
18Passos, VMA, Barreto, SM, Romanha, AJ, Krettli, AU, Volpini, AC, Gontijo, CMF et al. Cutaneous leishmaniasis in the metropolitan area of Belo Horizonte: clinical, laboratory, therapeutic and evolutionary aspects [in Portuguese]. Rev Soc Bras Med Trop 2001;34:5–12CrossRefGoogle Scholar
19Araújo, F. Vertigo in the elderly [in Portuguese]. Folha Méd (BR) 1994;108:5–12Google Scholar
20Grimby, A, Rosenhall, U. Health-related quality of life and dizziness in old age. Gerontology 1995;41:286–98CrossRefGoogle ScholarPubMed
21Ensrud, KE, Nevitt, MC, Yunis, C, Hulley, SB, Grimm, RH, Cummings, SR. Postural hypotension and postural dizziness in elderly women. The study of osteoporotic fractures. The Study of Osteoporotic Fractures Research Group. Arch Intern Med 1992;152:1058–64CrossRefGoogle Scholar
22Colledge, NR, Wilson, JA, Macintyre, CC, MacLennan, WJ. The prevalence and characteristics of dizziness in an elderly community. Age Ageing 1994;23:117–20CrossRefGoogle Scholar
23Colledge, NR, Barr-Hamilton, RM, Lewis, SJ, Sellar, RJ, Wilson, JA. Evaluation of investigations to diagnose the cause of dizziness in elderly people: a community based controlled study. BMJ 1996;313:788–92CrossRefGoogle ScholarPubMed
24Tinetti, ME, Williams, CS, Gill, TM. Dizziness among older adults: a possible geriatric syndrome. Ann Intern Med 2000;132:337–44CrossRefGoogle ScholarPubMed
25Tinetti, ME, Williams, CS, Gill, TM. Health, functional, and psychological outcomes among older persons with chronic dizziness. J Am Geriatr Soc 2000;48:417–21CrossRefGoogle ScholarPubMed
26Lopez-Escamez, JA, Lopez-Nevot, A, Gamiz, MJ, Moreno, PM, Bracero, F, Castillo, J et al. Diagnosis of common causes of vertigo using a structured clinical history [in Spanish]. Acta Otorrinolaringol Esp 2000;51:25–30Google ScholarPubMed
27Kao, AC, Nanda, A, Williams, CS, Tinetti, ME. Validation of dizziness as a possible geriatric syndrome. J Am Geriatr Soc 2001;49:72–5CrossRefGoogle ScholarPubMed
28Hearing loss and dizziness in the elderly: drugs and other associated factors [in Portuguese]. In: http://bases.bireme.br/cgi-bin/wxislind.exe/iah/online/ [25 June 2009]Google Scholar
29Katsarkas, A. Dizziness in aging: the clinical experience. Geriatrics 2008;63:18–20Google ScholarPubMed
30Davis, LE. Dizziness in elderly men. J Am Geriatr Soc 1994;42:1184–8CrossRefGoogle ScholarPubMed
31Lawson, J, Fitzgerald, J, Birchall, J, Aldren, CP, Kenny, RA. Diagnosis of geriatric patients with severe dizziness. J Am Geriatr Soc 1999;47:12–7CrossRefGoogle ScholarPubMed
32Piker, EG, Jacobson, GP, McCaslin, DL. Psychological comorbidities and their relationship to self-reported handicap in samples of dizzy patients. J Am Acad Audiol 2008;19:337–47Google ScholarPubMed
33AIDS Table for Grading Severity of Adult Adverse Experiences. In: http://www.aactg.s-3.com [18 May 2010]Google Scholar
34Tuon, FF, Amato, VS. Systematic review of New World cutaneous leishmaniasis: few points to be applied to Old World leismaniasis. Int J Dermatol 2009;48:201–2CrossRefGoogle Scholar
35Seligmann, H, Podoshin, L, Ben-Davis, J, Fradis, M, Goldsher, M. Drug-induced tinnitus and other hearing disorders. Drug Saf 1996;14:192–212CrossRefGoogle ScholarPubMed
36Hillen, ME, Wagner, ML, Sage, JI. “Subclinical” orthostatic hypotension is associated with dizziness in elderly patients with Parkinson Disease. Arch Phys Med Rehabil 1996;77:710–12CrossRefGoogle ScholarPubMed
37Walker, EM Jr, Fazekas-May, MM, Bowen, WR. Nephrotoxic and ototoxic agents. Int Clin Lab Med 1990;10:323–54CrossRefGoogle ScholarPubMed
38Humes, H. Insights into ototoxicity. Analogies to nephrotoxicity. Ann N Y Acad Sci 1999;28:15–18CrossRefGoogle Scholar
39Hyppolito, MA, Oliveira, JAA, Lessa, RM, Rossato, M. Amifostine otoprotection against cisplatin ototoxicity: guinea pig study using distortion product otoacoustic emissions and scanning electron microscopy [in Portuguese]. Rev Bras Otorrinolaringol 2005;71:268–73CrossRefGoogle ScholarPubMed
40Cohen, N. The patient with dizziness. Update on vestibular disorders [in Portuguese]. Med Clin North America 1991;6:1283–93Google Scholar
41Dukes, MNG, Aronson, JK. Meyler's Side Effects of Drugs, 14th ed.Amsterdam: Elsevier, 2000Google Scholar