[Acute renal failure in patient treated with ATRA and amphotericin B: case report].

This is a report of the case of a patient with acute promyelocytic leukemia treated with all trans-retinoic acid (ATRA), who had suspected all-trans retinoic acid syndrome (ATRA syndrome). The nonspecific febrile leukopenia observed justified the association with antimicrobial and antifungal therapy. Signs and symptoms contributed to the suspicion of ATRA syndrome, and renal function was impaired by the combination with antifungal agents. The decrease in renal function observed initially contributed to the suspicion of ATRA syndrome and was aggravated by antifungals. Thus, the use of ATRA was discontinued. Eight days after the pneumonia characterization, the possibility of ATRA syndrome was dismissed. In this context, ATR's nephrotoxicity and the synergic adverse effect by the use of nephrotoxic antifungal agents were discussed, particularly amphotericin B, as well as the importance of differential diagnosis between ATRA syndrome and infectious diseases.