par Vanhaeverbeek, Michel 
;Ectors, Michel Paul ;Vanhaelst, Luc ;Franken, Lucien
Référence Journal of neurology, neurosurgery and psychiatry, 37, 12, page (1343-1345)
Publication Publié, 1974
;Ectors, Michel Paul ;Vanhaelst, Luc ;Franken, Lucien Référence Journal of neurology, neurosurgery and psychiatry, 37, 12, page (1343-1345)
Publication Publié, 1974
Article révisé par les pairs
| Résumé : | Polymyxin E (Colistin) is a polypeptide antibiotic agent characterized by a remarkable activity against gram negative bacteria. The case is described of a 66 yr old man, who, treated with large doses of its sodium methane sulfonate derivative (CMS), presented with unusual neuromuscular manifestations. There were neurological disturbances indicating a frontal syndrome. His myopathy (the clinical features are presented) can be explained either by a direct lesion of the muscular membrane, or by an immunologic mechanism due to membrane modifications. The presence of muscle antibodies and of high IgA and IgG levels favors the latter hypothesis. The high blood eosinophil level present is sometimes observed as indicative of a massive release of mast cell histamine. It may represent either an antigen antibody reaction, or may be the result of the direct action of polymyxin E which is a mastocyte 'discharger'. Since CMS remains a first choice antibiotic because of its activity against gram negative bacteria, its frequent toxicity in man must be taken into account. The toxic reactions observed have a variable evolution. The myopathy regresses slowly; therefore the administration of CMS should be limited to indisputable bacteriologic and clinical indications. |
