ALTERAÇÕES LABORATORIAIS E EFEITOS ADVERSOS NO TRATAMENTO DA LEISHMANIOSE VISCERAL: HOSPITAL - ARAGUAÍNA-TO

Abstract

To describe the laboratory abnormalities and adverse events in patients presenting with visceral leishmaniasis treated by antimony in a reference center for tropical diseases in Araguaina TO held a retrospective study by systematic analysis of medical records in order to identify the laboratory abnormalities and adverse effects caused by the use of leishmanicidas, between the months of January to December 2008, evaluating the clinical, laboratory and treatment of patients at the Hospital for Tropical Diseases (HDT) in 253 patients. Although the drugs used effectively combat the parasite, they can cause undesirable side effects, whether by active ingredient or its metabolites. The diagnostic methods used were bone marrow aspirates (2.4%) and serology for immunofluorescence (94%), and (3.5%) probably the criterion was the clinical and epidemiological. Meglumine antimoniate showed high efficiency (70%) and more adverse effects reported were: liver enzyme elevations (0.45%) and pancreatic (1.79%), electrocardiographic abnormalities (4.07%), minor and reversible. Pancreatitis a serious adverse reaction was reported in 4 cases. Amphotericin B was used in 65 patients (25.6%), with 28 patients (11%) had failures in responding to glucantime, replaced by amphotericin B, 14 patients had recurrences and 14 (5.53%) died . The liposomal amphotericin B was used in 2 cases with severe kidney problems. Among the patients studied, 141 (55.73%) males, 112 females and age groups below 10 years was equivalent to 70%. In therapy with antimonials, 10 patients (4.5%) had arthralgia, 8 patients (3.6%) myalgia; 67pacientes (30.14%) weakness, 57 (25.6%) vomiting, (19.8%) change in weight, 28 (12.6%) palpitations. There were several signs and symptoms at admission: fever (95.5%), splenomegaly (60.7%), and hepatomegaly (49.1%). In hematological data were no changes in 106 (47.3%) in the other patients (118), the results were normal, because it is an emerging and very important, it is necessary to adopt a protocol for follow-up function renal and laboratory tests aimed at detecting abnormalities in the post-treatment and use of drugs that reduce these adverse effects.