Aminolevulinic-acid

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Aminolevulinic-acid Hypotension and elevation in alanine aminotransferase and aspartate aminotransferase levels: 11 case reports

In a retrospective single-center study of a total of 76 patients conducted between January 2018 and October 2019, 11 patients [including 1 woman and 6 men; not all sexes stated] aged 68–89 years were described, who developed hypotension or elevation in alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels following administration of aminolevulinic acid for photodynamic diagnosis of bladder cancer [time to reactions onset not stated]. The patients received aminolevulinic acid [Alaglio; 5-aminolevulinic acid] for photodynamic diagnosis (PDD) and assisted transurethral resection of bladder tumor (TURBT). Aminolevulinic acid was dissolved in 50mL of sodium chloride [normal saline]. This aqueous solution of aminolevulinic acid (20 mg/kg) was administered orally prior to the aminolevulinic acid-PDD-TURBT. The patients received general or spinal anaesthesia (unspecified). Seven of the 11 patients developed hypotension (n=7) with systolic BP of 64–89mm Hg, diastolic BP of 37–59mm Hg and mean arterial blood pressure of 47.3–65.3mm Hg. The remaining four patients developed grade I–III elevation in ALT and AST with ALT levels of 50–120 U/mL (ratio to upper normal range: 1.2–2.9), AST levels of 118–183 U/mL (ratio to upper normal range: 3.9–6.1) and AST/ALT of 1.1–3.7. The patients, who developed hypotension, were treated with ephedrine, epinephrine or norepinephrine, while the patient, who exhibited elevation of AST and ALT, did not received any treatment. Eventually, all side effects resolved. Yamamoto S, et al. Real-world experience with 5-aminolevulinic acid for the photodynamic diagnosis of bladder cancer: Diagnostic accuracy and safety. Photodiagnosis and 803518410 Photodynamic Therapy 32: 101999, Dec 2020. Available from: URL: http://doi.org/10.1016/j.pdpdt.2020.101999

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Reactions 5 Dec 2020 No. 1833

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