Posaconazole-induced hypertension and hypokalemia due to inhibition of the 11β-hydroxylase enzyme

被引：26

作者：

Barton, Kevin ^{[1
]}

Davis, T. Keefe ^{[1
]}

Marshall, Bess ^{[2
]}

Elward, Alexis ^{[3
]}

White, Neil H. ^{[2
]}

机构：

[1] Washington Univ, Dept Pediat, Div Nephrol, St Louis, MO 63130 USA

[2] Washington Univ, Dept Pediat, Div Endocrinol, St Louis, MO 63130 USA

[3] Washington Univ, Dept Pediat, Div Infect Dis, St Louis, MO 63130 USA

来源：

CLINICAL KIDNEY JOURNAL | 2018年 / 11卷 / 05期

关键词：

adrenal hyperplasia; 11; beta-hydroxylase; hypertension; hypokalemia; mineralocorticoid excess; posaconazole; PHEOCHROMOCYTOMA;

D O I：

10.1093/ckj/sfx156

中图分类号：

R5 [内科学]; R69 [泌尿科学（泌尿生殖系疾病）];

学科分类号：

1002 ; 100201 ;

摘要：

Posaconazole is an antifungal therapy reported to cause incident hypertension. Hypokalemia is also a known side effect. The combination of hypertension and hypokalemia suggests mineralocorticoid excess. We present the case of a 15-year-old adolescent male with hypertensive urgency while on prophylactic posaconazole therapy for a combined immunodeficiency. We identify the mechanism of posaconazole-induced hypertension to be inhibition of the 11 beta-hydroxylase enzyme, resulting in elevated levels of the mineralocorticoid receptor activator deoxycorticosterone. Loss of function of the 11 beta-hydroxylase enzyme is responsible for a rare form of congenital adrenal hyperplasia and can be associated with life-threatening adrenal crisis.

引用

页码：691 / 693

页数：3

共 6 条

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