Hipoglucemia severa secundaria a pentamidina intravenosa en mujer receptora de un trasplante alogénico de progenitores hematopoyéticos

espanolLas personas tratadas mediante trasplante de progenitores hematopoyeticos (TPH) presentan una predisposicion especial a desarrollar infecciones. Los patogenos mas frecuentes son la Candida y el Aspergillus, los cuales comportan una elevada morbimortalidad. El tratamiento de eleccion para la infeccion por Pneumocystis Jiroveci es trimetoprim-sulfametoxazole (TMP-SMX). La intolerancia a TMP-SMZ o una situacion de mielosupresion, situacion habitual en el paciente receptor de TPH, precisan en ocasiones del uso de pentamidina. Durante su administracion, intravenosa o inhalada, debe ser monitorizada la glucosa, puesto que han sido reportadas alteraciones de los niveles de glucosa en sangre. Son escasos los pacientes que precisan prescripcion de pentamidina intravenosa, pero debido al alto riesgo de hipoglucemia severa, su administracion requiere de un protocolo de cuidado especifico. El objetivo del presente caso clinico es dar a conocer el protocolo de dieta hiperfraccionada en el paciente sometido a trasplante hematopoyetico durante el tratamiento con dicho farmaco. EnglishThose patients receiving a stem cell transplant (SCT) as treatment will present a particular tendency to develop infections. The most frequent pathogens are Candida and Aspergillus, which entail a high morbimortality rate. The treatment of choice for infection by Pneumocystis Jiroveci is Trimethoprim/sulfamethoxazole (TMP/SMX). Lack of tolerability to TMP-SMX or myelosuppression, which is a common situation among patients receiving a SCT, will sometimes require the use of pentamidine. During its administration, either intravenous or inhaled, glucose levels must be monitored, because there have been reports about alterations of the levels of glucose in blood. There are few patients who require a prescription of intravenous pentamidine, but due to the high risk of severe hypoglycaemia, its administration requires a specific protocol of care. The objective of the present clinical case is to create awareness about the protocol for hyperfractionated diet in patients undergoing stem cell transplant, during treatment with said drug.