A 32-year-old Haitian male with acquired immunodeficiency syndrome presented with complications of Isospora belli enteritis. Therapy with the investigational drug difluoromethylornithine was initiated. Severe thrombocytopenia, nausea, and vomiting developed during intravenous drug therapy and recurred upon rechallenge with low-dose oral difluoromethylornithine. Therapy was discontinued because of these severe adverse effects.
GaskaJATietzeKJCosgroveEM.Unsuccessful treatment of enteritis due to Isospora belli with spiramycin: a case report.J Infect Dis1985; 152: 1336–8.
2.
ArmstrongDGoldJWMDryjanskiJ, Treatment of infections in patients with the acquired immunodeficiency syndrome.Ann Intern Med1985; 103: 738–43.
3.
GoldJWMArmstrongD.Infectious complications of the acquired immune deficiency syndrome.Ann NY Acad Sci1984; 437: 383–93.
4.
Centers for Disease Control.Revision of the case definition of acquired immunodeficiency syndrome for national reporting-United States.Ann Intern Med1985; 103:402–3.
Centers for Disease Control.Cryptosporidiosis: asssessment of chemotherapy of males with acquired immune deficiency syndrome (AIDS).MMWR1983; 31:589–92.
7.
HughesJMGuerrantRL.Systemic syndromes complicating gastrointestinal infections. In: MandelGLDouglasRGJrBennettJE, eds. Principles and practice of infectious diseases.New York: John Wiley and Sons, 1979: 890–907.
8.
BrandborgLLGoldbergSBBreidenbachWC.Human coccidiosis—a possible cause of malabsorption: the life cycle in small-bowel mucosal biopsies as a diagnostic feature.N Engl J Med1970; 283: 1306–13.
9.
GuerrantRL.Inflammatory enteritides. In: MandelGLDouglasRGJr, eds. Principles and practice of infectious diseases.New York: John Wiley and Sons, 1979: 876–89.
10.
FrenchJWWhitbyJLWhitfieldAGW.Steatorrhea in a man infected with coccidiosis (Isospora belli).Gastroenterology1964; 47: 642–8.
11.
ModiglianiRBoriesCCharpenterYLDiarrhea and malabsorption in acquired immune deficiency syndrome: a study of four cases with special emphasis on opportunistic protozoan infestations.Gut1985; 26: 179–87.
12.
ForthalDN.I. belli enteritis in three homosexual men.Am J Trop Med Hyg1984; 33: 1060–4.
13.
VeldhuyzENVan ZantenSSOLargeJMASauerweinHP, Amprolium for coccidiosis in AIDS.Lancet1984; 2: 345–6.
14.
SloperKSDourmashkinRRBirdRBChronic malabsorption due to cryptosporidiosis in a child with immunoglobulin deficiency.Gut1982; 23: 80–2.
15.
TrierJSMoxeyPCSchimmelEMRoblesE.Chronic intestinal coccidiosis in man: intestinal morphology and response to treatment.Gastroenterology1975; 66: 923–35.
16.
PeggAEWilliams-AshmanMG.Biosynthesis of putrescine in the prostate gland of the rat.Biochem J1968; 708: 533–9.
17.
RussellDSnyderSH.Amine synthesis in rapidly growing tissues: ornithine decarboxylase activity in regenerating rat liver, chick embryo, and various tumors.Biochem J1968; 108: 533–9.
18.
PeggAEMccannPP.Polyamine metabolism and function.Am J Physiol1982; 243: C212–21.
19.
MamontPSDuchesneMCGroveJBeyP.Anti-proliferative properties of dl-α-difluoromethylornithine in cultured cells. A consequence of the irreversible inhibition of ornithine decarboxylase.Biochem Biophys Res Commun1978; 81: 58–66.
20.
FozardJRPartM-LPrakashNJGroveJ.Inhibition of murine embryonic development by α-difluoromethylornithine, an irreversible inhibitor of ornithine decarboxylase.Eur J Pharmacol1980; 65: 379–91.
21.
FozardJRPartM-LPrakashNJ, L-ornithine decarboxylase: an essential role in early mammalian embryogenesis.Science1980; 208: 505–8.
22.
GibsonWVan BreemenRFieldsALafeminaRIrmiereA. D.L-α-difluoromethyl-ornithine inhibits human cytomegalovirus replication.J Virol1984; 50: 145–54.
23.
RainaATuomIKPajulaRL.Synthesis of macromolecules and viruses in cells treated with inhibitors of polyamine synthesis.Adv Polyamine Res1981; 3: 163–73.
24.
AbeloffMDSlavikMLukGDPhase I trial and pharmacokinteic studies of α-difluoromethylornithine—an inhibitor of polyamine biosynthesis.J Clin Oncol1984; 2: 124–30.
25.
SjoerdsmaASchecterPJ.Chemotherapeutic implications of polyamine biosynthesis inhibition.Clin Pharmacol Ther1984; 35: 287–300.
26.
BacchiCJNathanMCHutnerSHMccannPPSjoerdsmaA.Polyamine metabolism: a potential therapeutic target in try-panosomes.Science1980; 210: 332–4.
27.
BacchiCJ.Content, synthesis, and function of polyamines in trypanosomatids: relationship to chemotherapy.J Protozool1981; 28: 20–7.
28.
MccannPPBacchiCJClarksonABFurther studies on difluoromethylornithine in African trypanosomes.Med Biol1981; 59: 434–40.
29.
HansonWLBradfordMMChapmanWLWaitsVBMccannPPSjoerdsmaA.α-Difluoromethylornithine: a promising lead for preventive chemotherapy for coccidiosis.Am J Vet Res1982; 43: 1651–3.
30.
GoldenJASjoerdsmaASantiDV.Pneumocystis carinii pneumonia treated with α-difluoromethylornithine.West J Med1984; 141: 613–23.
31.
GilletJMCharlierJBoneGMulambaPL.Plasmodium berghei: inhibition of the sporogonous cycle by α-difluoromethylornithine.Exp Parasitol1983; 56: 190–3.
32.
WhaunJMBrownND.Ornithine decarboxylase inhibition and the malaria-infected red cell: a model for polyamine metabolism and growth.J Pharmacol Exp Ther1985; 233: 507–11.
33.
GillinFDReinerDSMccannPP.Inhibition of growth of Giardia lamblia by difluoromethlyornithine, a specific inhibitor of polyamine biosynthesis.J Protozool1984; 31: 161–3.
34.
MccannppBacchiCJHansonWLEffect on parasitic protozoa of α-difluoromethlyornithine—an inhibitor of ornithine decarboxylase. In: CaldareaCMZappiaVBackrackU, eds. New York: Raven Press, 1981: 79–110.
35.
HaegeleKDAlkenRGGroveJSchecterPJKoch-WeserJ.Kinetics of α-difluoromethylornithine: an irreversible inhibitor of ornithine decarboxylase.Clin Pharmacol Ther1981; 30: 210–7.
36.
HutchinsonTALeventhalJMKramerMSKarchFELipmanAGFeinsteinAR.An algorithm for the operational assessment of adverse drug reactions. II. Demonstration of reproducibility and validity.JAMA1979; 242: 633–8.
