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Pentamidine is a drug that has increasingly been used to treat and prevent Pneumocystis carinii pneumonia (PCP), an opportunistic infection which frequently occurs in association with AIDS. A case is reported of a 28-year-old man with AIDS who developed very low blood levels of calcium and magnesium after treatment with pentamidine. The patient had a past history of syphilis, brain infection, rectal herpes infection, and a medication-associated fever. On admission, PCP was diagnosed and the patient was given pentamidine intravenously. Acute kidney failure developed on the fourth day of pentamidine treatment, and muscular and other symptoms associated with low blood magnesium and calcium levels developed on the tenth day. Calcium and magnesium supplements were given for two weeks, and systemic pentamidine therapy was discontinued on the tenth day due to kidney failure. Pentamidine was administered as an inhalant form, and the patient improved. Three months after the episode, calcium and magnesium levels were close to normal. Although kidney failure has been observed in 23 to 95 percent of patients treated with systemic pentamidine, this is the first report of pentamidine-associated kidney magnesium wasting. Other causes of hypomagnesemia, such as hypoparathyroidism, disturbed vitamin D metabolism, or pancreatitis were excluded in this patient. (Consumer Summary produced by Reliance Medical Information, Inc.)

THERE is increasing awareness that long-term abuse of various analgesic agents is a major factor in the pathogenesis of renal papillary necrosis (RPN), which is an important cause of renal dysfunction. We describe a patient who experienced RPN while taking large doses of pentazocine in association with aspirin.Report of a CaseA 49-year-old white man was admitted to the Long Beach (Calif) Veterans Administration Medical Center in October 1978 with a two-day history of lower abdominal pain radiating to both flanks. The pain was partially relieved by position change and was associated with nausea and vomiting. The only other symptom was passage of tissue via the urethra. A similar episode had occurred in August 1978. An excretory urogram obtained in April 1978 for evaluation of weight loss was normal. History included chronic alcoholism with hepatic cirrhosis, chronic pancreatitis, chemical diabetes mellitus, and cholelithiasis. He had been taking aspirin (1.8