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

• 見坂, 恒明

• Sugimoto, Kazuma

• 合田, 建

• Akita, Hozuka

抄録

Introduction: Acyclovir (ACV)-associated encephalopathy is related to an increase in plasma levels of 9-carboxymethoxymethylguanine, an ACV metabolite, and is often reported in patients with renal dysfunction. We report a case of ACV-associated encephalopathy with rapid progression of renal dysfunction after oral administration of valacyclovir (VACV) and review literature of previous ACV-associated encephalopathy cases. Patient concerns: An 88-year-old man was diagnosed with herpes zoster. VACV (3000 mg/day) treatment was initiated. Serum creatinine (Cr) level was 0.80 mg/dL. However, irritability, memory impairment, and decreased responsiveness occurred after 3 days. The Cr level was 6.76 mg/dL on admission. Diagnosis: He was diagnosed with ACV-associated encephalopathy with acute kidney injury. Interventions: VACV was discontinued, hemodialysis was initiated on the day of admission, and then the signs and symptoms improved approximately 72 hours after the admission. Conclusion: Worsening of renal function and encephalopathy should be a focus when using VACV or ACV, regardless of age and original renal function. Acute kidney injury and ACV-associated encephalopathy may particularly occur in the elderly even when renal function is normal. Therefore, regular monitoring of renal function and consciousness is necessary during VACV treatment.

収録刊行物

• Medicine

  Medicine 100 (21), e26147-, 2021-05-28

  Lippincott Williams & Wilkins

キーワード

• acute kidney injury
• acyclovir neurotoxicity
• case report
• herpes zoster
• valacyclovir

詳細情報

• CRID: 1050012570391650176
• NII論文ID: 120007098992
• NII書誌ID: AA00728867
• ISSN: 15365964
• ISSN: 00257974
• HANDLE: 20.500.14094/90008409
• 本文言語コード: en
• 資料種別: journal article
• データソース種別:
  • IRDB
  • CiNii Articles