A Study of Hematologic, Hepatic and Renal Side Effects of Intramuscular Injection of Meglumine Antimoniate (Glucantime) on Patients with Cutaneous Leishmaniasis

Document Type : Research Paper




ntroduction: Cutaneous leishmaniasis is an endemic disease in many countries that is caused by different species of Leishmania. Nowadays, standard medication for leishmaniasis is pentavalent antimony compounds that are used intramuscular or intralesional. Though, they are drugs of choice, there are limitations such as hematologic, hepatic, renal and cardiac side effects. This study reviewed hematological, hepatic, and renal side effects of glucantim.
Material and Methods: The present work was a pre- and post- treatment study on 35 patients with cutaneous leishmaniasis referred to Dermatology Department, Imam Reza Hospital, Mashhad. Their disease was confirmed by direct smear. The patients were treated with intramuscular glucantime 60mg/kg daily for 20 days. Complete blood count (CBC, diff), serum glutamic oxaloacetic transaminase (SGOT), serum glutamic pyruvic transaminase (SGPT), blood urea nitrogen (BUN), creatinine(Cr) were evaluted at 3 times: before treatment, on the 20th day of treatment course (last day of injection), and a month after the end of treatment. Demographic, laboratory and treatment results, and drug complications were recorded in a questionnaire. Data were analyzed by descriptive statistics.
Results: Of35 patients in this study, 26 completed the course. Red blood cell count, hemoglobin and hematocrit levels significantly reduced (P<0.05), but no significant difference was shown in white blood cell and platelet count. The increase of serum SGOT and SGPT levels were considerable (P<0.05). Elevated serum levels of Cr and BUN observed in 11.5% and 34.6% of patients, respectively; and renal side effects were more common in females than in males (64% in females VS 10% in males).
Conclusion: Systemic glucantime is associated with hematologic, hepatic, and renal side effects. Therefore, evaluation of hematologic, hepatic and renal statement in patients receiving glucantim, before and during treatment is suggested.