Encephalopathy and acute renal failure during acyclovir treatment

Revue neurologique
A DellucJ-Y Goas

Abstract

Adverse neurological and renal effects can occur in patients taking acyclovir. Neurotoxicity of acyclovir results from an accumulation of the antiviral and its metabolites in the bloodstream. This can be observed in the elderly or in patients with chronic renal failure, generally in dialysis patients. Acute renal failure results from intratubular crystallization of acyclovir. A 78-year-old right-handed woman was admitted in an emergency setting for aphasia. Analysis of the cerebrospinal fluid was normal, but herpetic meningo-encephalitis was suspected and intravenous treatment was initiated with acyclovir. After the second infusion, the patient began to suffer from visual hallucinations, confusion and acute renal failure. Herpes PCR was negative in the cerebrospinal fluid, and the adverse drug reactions regressed completely after 72 hours. Renal function has to be checked often in patients given acyclovir for appropriate dose titration. Patients recover prompt from the adverse effects at drug withdrawal.

References

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Jun 29, 2002·Archives of Pathology & Laboratory Medicine·Andrew W LyonMartin J Trotter
May 16, 2003·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Anders HelldénLars Ståhle

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Citations

Jan 20, 2017·Experimental and Therapeutic Medicine·Yanning ZhangYan Teng
Jan 1, 2011·World Journal of Emergency Medicine·Jian-Biao MengQiang Fang
Jun 20, 2021·Journal of Clinical Pharmacy and Therapeutics·David Brandariz-NuñezIsabel Martín Herranz
Feb 2, 2010·Néphrologie & thérapeutique·Erika Nnang ObadaPascal Bindi

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