Administration of liposomal amphotericin B induces renal dysfunction in a patient with adult Still’s disease treated with cyclosporine A

Abstract

A 57-year-old woman presented with fever, elevated β-D-glucan, and Aspergillus antigen in the blood. She had been diagnosed as having refractory Still’s disease and was being treated with cyclosporine A (CyA) and cyclophosphamide. She was administered liposomal amphotericin B (L-AMPH-B) because it was felt that she could have a fungal infection; after that, her levels of serum creatinine and blood urea nitrogen rapidly increased. Deteriorated renal function was observed thereafter. It was concluded that the combination of L-AMPH-B and CyA induced the acute renal failure, and that the subsequent deterioration in renal function was triggered by CyA. Thus, if amphotericin B is administered together with CyA, there is the need to repeatedly measure renal function and reduce the dosage of CyA if necessary.