Reversible skeletal disease and high fluoride serum levels in hematologic patients receiving voriconazole.
Blood
; 120(12): 2390-4, 2012 Sep 20.
Article
em En
| MEDLINE
| ID: mdl-22859610
ABSTRACT
We here investigate the occurrence of fluoride intake-associated alterations in patients with hematologic disease on triazol antifungal medication. Clinical, laboratory, and radiology data of overall 43 patients with hematologic malignancies taking voriconazole (n = 20), posaconazole (n = 8), and itraconazole (n = 4), and a hematologic patient control group (n = 11) are described. Bone pain and radiologic evidence of periostitis were exclusively observed in patients receiving long-term voriconazole. Cessation of treatment led to clinical improvement in all cases. In line with clinical evidence, fluoride serum concentration was elevated in patients receiving voriconazole (median, 156.5 µg/L; interquartile range, 96.8 µg/L; normal < 30 µg/L) but not in the other treatment groups (P < .001 for all comparisons vs voriconazole). We conclude that serum fluoride levels were elevated on average 5-fold above normal levels in hematologic patients receiving voriconazole. Clinically relevant skeletal disease was associated with renal insufficiency and above 10-fold elevated fluoride levels, and was reversible on termination of voriconazole treatment.
Buscar no Google
Base de dados:
MEDLINE
Assunto principal:
Doenças Ósseas
/
Músculo Esquelético
/
Neoplasias Hematológicas
/
Fluoretos
/
Antifúngicos
Tipo de estudo:
Observational_studies
/
Risk_factors_studies
Limite:
Adult
/
Female
/
Humans
/
Middle aged
Idioma:
En
Revista:
Blood
Ano de publicação:
2012
Tipo de documento:
Article
País de afiliação:
Suíça