Study of hepatobiliary system functional parameters in patients with impaired carbohydrate tolerance under systemic antimycotic therapy

Onychomycosis is a long-standing challenging problem. Effective treatment of patients with onychomycosis is a difficult task. Genetically determined resistance of micromycetes to drugs and acquired resistance contribute to problematic treatment. Systemic antimycotic therapy is conducted in case of total or multiple lesions of ungueal plates. The problem of hepatotoxicity of systemic antimycotics is known; however, lesion pattern in patients with onychomycosis and impaired carbohydrate tolerance are still understudied. The purpose of the work is to study functional changes in the main indicators of the hepatobiliary system in patients with impaired carbohydrate tolerance under antimycotic therapy. Materials and Methods. The study enrolled 11 patients with impaired carbohydrate tolerance. They underwent a biochemical blood test before treatment with oral antimycotic drugs and a month after treatment onset. At presentation, 4 patients revealed a slight increase in total bilirubin and ALT; other findings were normal. Patients took systemic antifungal drugs, providing for the identified sensitivity of pathogens. Results. All patients under antimycotic therapy demonstrated a statistically significant increase in liver tests. Conclusion. The revealed changes in the hepatobiliary system under a pronounced load in case of systemic antimycotic therapy allow us to develop an algorithm for diagnosis and treatment of onychomycosis in patients with impaired carbohydrate tolerance.