Case Report
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Acute kidney injury and neurological toxicity caused by intravenous acyclovir

Year 2022, Volume: 27 Issue: 3, 337 - 341, 27.09.2022

Cebrail Karaca Sena Fidan Yalcın Gul Ayse Ozdede Nurhan Seyahi Emire Seyahi

https://doi.org/10.21673/anadoluklin.1062502

Abstract

Acyclovir is an effective antiviral agent in herpes simplex and varicella-zoster infections treatments. However, it may cause serious side effects. This case study reports a patient who developed both acute tubular necrosis and neurotoxicity induced by intravenous acyclovir and recovered promptly after hemodialysis. Caution is needed in monitoring patients receiving acyclovir. Eliminating acyclovir with early diagnosis and immediate daily hemodialysis is necessary for successful treatment.

Keywords

acyclovir acute kidney injury hemodialysis neurotoxicity

References

  • Lee EJ, Jang HN, Cho HS, et al. The incidence, risk factors, and clinical outcomes of acute kidney injury (staged using the RIFLE classification) associated with intravenous acyclovir administration. Ren Fail. 2018;40(1):687-92.
  • Perazella MA. Crystal-induced acute renal failure. Am J Med. 1999;106(4):459-65.
  • Krieble BF, Rudy DW, Glick MR, Clayman MD. Case report: acyclovir neurotoxicity and nephrotoxicity--the role for hemodialysis. Am J Med Sci. 1993;305(1):36-9.
  • Dubrofsky L, Kerzner RS, Delaunay C, Kolenda C, Pepin J, Schwartz BC. Interdisciplinary Systems-Based Intervention to Improve IV Hydration during Parenteral Administration of Acyclovir. Can J Hosp Pharm. 2016;69(1):7-13.
  • Richelsen RKB, Jensen SB, Nielsen H. Incidence and predictors of intravenous acyclovir-induced nephrotoxicity. Eur J Clin Microbiol Infect Dis. 2018;37(10):1965-71.
  • Haefeli WE, Schoenenberger RA, Weiss P, Ritz RF. Acyclovir-induced neurotoxicity: concentration-side effect relationship in acyclovir overdose. Am J Med. 1993;94(2):212-5.
  • Adair JC, Gold M, Bond RE. Acyclovir neurotoxicity: clinical experience and review of the literature. South Med J. 1994;87(12):1227-31.
  • Chowdhury MA, Derar N, Hasan S, Hinch B, Ratnam S, Assaly R. Acyclovir-Induced Neurotoxicity: A Case Report and Review of Literature. Am J Ther. 2016;23(3):e941-3.
  • Hellden A, Lycke J, Vander T, Svensson JO, Odar-Cederlof I, Stahle L. The aciclovir metabolite CMMG is detectable in the CSF of subjects with neuropsychiatric symptoms during aciclovir and valaciclovir treatment. J Antimicrob Chemother. 2006;57(5):945-9.
  • Yang HH, Hsiao YP, Shih HC, Yang JH. Acyclovir-induced neuropsychosis successfully recovered after immediate hemodialysis in an end-stage renal disease patient. Int J Dermatol. 2007;46(8):883-4.
  • Patel J, Hayes B, Bauler L, Mastenbrook J. Neurologic Acyclovir Toxicity in the Absence of Kidney Injury. J Emerg Med. 2019;57(2):e35-e9.
  • Brady M, Main J. Aciclovir neurotoxicity is an important side effect of therapy in patients with renal impairment. Clin Med (Lond). 2009;9(6):630.
  • Vander T, Medvedovsky M, Herishanu Y. Encephalopathy induced by oral acyclovir in a patient with normal renal function. J Infect. 2003;46(4):286.
  • Fleischer R, Johnson M. Acyclovir nephrotoxicity: a case report highlighting the importance of prevention, detection, and treatment of acyclovir-induced nephropathy. Case Rep Med. 2010;2010.
  • Kenzaka T, Sugimoto K, Goda K, Akita H. Acute kidney injury and acyclovir-associated encephalopathy after administration of valacyclovir in an elderly person with normal renal function: A case report and literature review. Medicine (Baltimore). 2021;100(21):e26147.

İntravenöz asiklovirin neden olduğu akut böbrek hasarı ve nörolojik toksisite

Year 2022, Volume: 27 Issue: 3, 337 - 341, 27.09.2022

Cebrail Karaca Sena Fidan Yalcın Gul Ayse Ozdede Nurhan Seyahi Emire Seyahi

https://doi.org/10.21673/anadoluklin.1062502

Abstract

Asiklovir, herpes simplex ve varicella-zoster enfeksiyonlarının tedavisinde etkili bir antiviral ajandır. Ancak ciddi yan etkilere neden olabilir. Bu makelede intravenöz asiklovir ile indüklenen, hem akut tübüler nekroz hem de nörotoksisite gelişen ve hemodiyaliz sonrasında klinik tablonun hızla düzeldiği bir hastayı sunuyoruz. Asiklovir ile tedavi edilen hastaların izlenmesinde dikkatli olunmalıdır. Bu hastaların başarılı tedavisi için erken tanı konulmalı ve asiklovirin elimine edilmesi için hızlıca hemodiyaliz uygulanmalıdır.

Keywords

asiklovir akut böbrek hasarı hemodiyaliz nörotoksisite

References

  • Lee EJ, Jang HN, Cho HS, et al. The incidence, risk factors, and clinical outcomes of acute kidney injury (staged using the RIFLE classification) associated with intravenous acyclovir administration. Ren Fail. 2018;40(1):687-92.
  • Perazella MA. Crystal-induced acute renal failure. Am J Med. 1999;106(4):459-65.
  • Krieble BF, Rudy DW, Glick MR, Clayman MD. Case report: acyclovir neurotoxicity and nephrotoxicity--the role for hemodialysis. Am J Med Sci. 1993;305(1):36-9.
  • Dubrofsky L, Kerzner RS, Delaunay C, Kolenda C, Pepin J, Schwartz BC. Interdisciplinary Systems-Based Intervention to Improve IV Hydration during Parenteral Administration of Acyclovir. Can J Hosp Pharm. 2016;69(1):7-13.
  • Richelsen RKB, Jensen SB, Nielsen H. Incidence and predictors of intravenous acyclovir-induced nephrotoxicity. Eur J Clin Microbiol Infect Dis. 2018;37(10):1965-71.
  • Haefeli WE, Schoenenberger RA, Weiss P, Ritz RF. Acyclovir-induced neurotoxicity: concentration-side effect relationship in acyclovir overdose. Am J Med. 1993;94(2):212-5.
  • Adair JC, Gold M, Bond RE. Acyclovir neurotoxicity: clinical experience and review of the literature. South Med J. 1994;87(12):1227-31.
  • Chowdhury MA, Derar N, Hasan S, Hinch B, Ratnam S, Assaly R. Acyclovir-Induced Neurotoxicity: A Case Report and Review of Literature. Am J Ther. 2016;23(3):e941-3.
  • Hellden A, Lycke J, Vander T, Svensson JO, Odar-Cederlof I, Stahle L. The aciclovir metabolite CMMG is detectable in the CSF of subjects with neuropsychiatric symptoms during aciclovir and valaciclovir treatment. J Antimicrob Chemother. 2006;57(5):945-9.
  • Yang HH, Hsiao YP, Shih HC, Yang JH. Acyclovir-induced neuropsychosis successfully recovered after immediate hemodialysis in an end-stage renal disease patient. Int J Dermatol. 2007;46(8):883-4.
  • Patel J, Hayes B, Bauler L, Mastenbrook J. Neurologic Acyclovir Toxicity in the Absence of Kidney Injury. J Emerg Med. 2019;57(2):e35-e9.
  • Brady M, Main J. Aciclovir neurotoxicity is an important side effect of therapy in patients with renal impairment. Clin Med (Lond). 2009;9(6):630.
  • Vander T, Medvedovsky M, Herishanu Y. Encephalopathy induced by oral acyclovir in a patient with normal renal function. J Infect. 2003;46(4):286.
  • Fleischer R, Johnson M. Acyclovir nephrotoxicity: a case report highlighting the importance of prevention, detection, and treatment of acyclovir-induced nephropathy. Case Rep Med. 2010;2010.
  • Kenzaka T, Sugimoto K, Goda K, Akita H. Acute kidney injury and acyclovir-associated encephalopathy after administration of valacyclovir in an elderly person with normal renal function: A case report and literature review. Medicine (Baltimore). 2021;100(21):e26147.
There are 15 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section CASE REPORT
Authors

Cebrail Karaca 0000-0003-0969-7708

Sena Fidan This is me 0000-0001-8895-296X

Yalcın Gul This is me 0000-0001-8944-0712

Ayse Ozdede This is me 0000-0002-6531-8138

Nurhan Seyahi 0000-0001-7427-618X

Emire Seyahi 0000-0003-4965-2918

Publication Date September 27, 2022
Acceptance Date April 24, 2022
Published in Issue Year 2022 Volume: 27 Issue: 3

Cite

Vancouver Karaca C, Fidan S, Gul Y, Ozdede A, Seyahi N, Seyahi E. Acute kidney injury and neurological toxicity caused by intravenous acyclovir. Anatolian Clin. 2022;27(3):337-41.
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