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Reversible Hepatic Dysfunction Owing to Guanidine Treatment

Reversible Hepatic Dysfunction Owing to Guanidine Treatment Abstract To the Editor.— Guanidine hydrochloride is of value in the treatment of the Lambert-Eaton syndrome1 and botulism.2 More recently, it was tried in the treatment of motor neuron disease.3Untoward side effects are frequent and include the following: cholinergic reactions of the gastrointestional (GI) system, paresthesias, skin changes, petechiae, and, with high doses, nervousness, tremors, and ataxia1,3,4 More serious are the occasional occurrences of bone marrow depression and aplastic anemia3,4 and probably long-term renal impairment.5,6 Lambert and Howard4 and Henriksson et al6 mention one patient with elevation of alkaline phosphatase level and other indicators of hepatic dysfunction, which reverted to a normal level after discontinuation of treatment with the drug. Norris et al3 have treated more than 200 patients with various doses of guanidine. Liver function abnormalities are not mentioned in their study. We describe a patient with the Lambert-Eaton syndrome References 1. Oh SJ, Kim KW: Guanidine hydrochloride in the Eaton-Lambert syndrome . Neurol 23:1084-1090, 1973.Crossref 2. Ryan DW, Cherington M: Human type A botulism . JAMA 216:513-514, 1971.Crossref 3. Norris FH, Calanchini, PR, Fallat, RJ et al: The administration of guanidine in amyotrophic lateral sclerosis . Neurol 24:721-728, 1974.Crossref 4. Lambert EH, Howard FM: Complications of guanidine treatment. Presented to the annual Myasthenia Gravis Foundation meeting, New York, Dec 6, 1972. 5. Blumhardt LD, Joekes AM, Marshall J, et al: Guanidine treatment and impaired renal function in the Eaton-Lambert syndrome . Br Med J 1:946-947, 1977.Crossref 6. Henriksson KG, Nilsson O, Rosen J, et al: Clinical neurophysiological and morphological findings in Eaton-Lambert syndrome . Acta Neurol Scand 56:117-140, 1977.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Neurology American Medical Association

Reversible Hepatic Dysfunction Owing to Guanidine Treatment

Archives of Neurology , Volume 36 (6) – Jun 1, 1979

Reversible Hepatic Dysfunction Owing to Guanidine Treatment

Abstract

Abstract To the Editor.— Guanidine hydrochloride is of value in the treatment of the Lambert-Eaton syndrome1 and botulism.2 More recently, it was tried in the treatment of motor neuron disease.3Untoward side effects are frequent and include the following: cholinergic reactions of the gastrointestional (GI) system, paresthesias, skin changes, petechiae, and, with high doses, nervousness, tremors, and ataxia1,3,4 More serious are the occasional occurrences of bone marrow depression and...
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References (5)

Publisher
American Medical Association
Copyright
Copyright © 1979 American Medical Association. All Rights Reserved.
ISSN
0003-9942
eISSN
1538-3687
DOI
10.1001/archneur.1979.00500420096017
Publisher site
See Article on Publisher Site

Abstract

Abstract To the Editor.— Guanidine hydrochloride is of value in the treatment of the Lambert-Eaton syndrome1 and botulism.2 More recently, it was tried in the treatment of motor neuron disease.3Untoward side effects are frequent and include the following: cholinergic reactions of the gastrointestional (GI) system, paresthesias, skin changes, petechiae, and, with high doses, nervousness, tremors, and ataxia1,3,4 More serious are the occasional occurrences of bone marrow depression and aplastic anemia3,4 and probably long-term renal impairment.5,6 Lambert and Howard4 and Henriksson et al6 mention one patient with elevation of alkaline phosphatase level and other indicators of hepatic dysfunction, which reverted to a normal level after discontinuation of treatment with the drug. Norris et al3 have treated more than 200 patients with various doses of guanidine. Liver function abnormalities are not mentioned in their study. We describe a patient with the Lambert-Eaton syndrome References 1. Oh SJ, Kim KW: Guanidine hydrochloride in the Eaton-Lambert syndrome . Neurol 23:1084-1090, 1973.Crossref 2. Ryan DW, Cherington M: Human type A botulism . JAMA 216:513-514, 1971.Crossref 3. Norris FH, Calanchini, PR, Fallat, RJ et al: The administration of guanidine in amyotrophic lateral sclerosis . Neurol 24:721-728, 1974.Crossref 4. Lambert EH, Howard FM: Complications of guanidine treatment. Presented to the annual Myasthenia Gravis Foundation meeting, New York, Dec 6, 1972. 5. Blumhardt LD, Joekes AM, Marshall J, et al: Guanidine treatment and impaired renal function in the Eaton-Lambert syndrome . Br Med J 1:946-947, 1977.Crossref 6. Henriksson KG, Nilsson O, Rosen J, et al: Clinical neurophysiological and morphological findings in Eaton-Lambert syndrome . Acta Neurol Scand 56:117-140, 1977.Crossref

Journal

Archives of NeurologyAmerican Medical Association

Published: Jun 1, 1979

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