Open AccessValacyclovir Neurotoxicity and Nephrotoxicity in an Elderly Patient Complicated by Hyponatremia
Author(s) -
Takuya Murakami,
Tetsu Akimoto,
Mari Okada,
Erika Hishida,
Taro Sugase,
Atsushi Miki,
Marina Kohara,
Hiromichi Yoshizawa,
Takahiro Masuda,
Takahisa Kobayashi,
Osamu Saito,
Shigeaki Muto,
Daisuke Nagata
Publication year - 2018
Publication title -
drug target insights
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.297
H-Index - 12
ISSN - 1177-3928
DOI - 10.33393/dti.2018.1400
Subject(s) - medicine , nephrotoxicity , hyponatremia , renal function , neurotoxicity , creatinine , coma (optics) , intensive care medicine , acute kidney injury , pediatrics , kidney , toxicity , optics , physics
A 66-year-old women with no history of renal disease was admitted due to a coma and acute kidney injury with a serum creatinine level of 7.44 mg/dL which were ascribed to valacyclovir neurotoxicity and nephrotoxicity, respectively. She had received valacyclovir at a standard dosage for the treatment of herpes zoster and was finally discharged, having fully returned to her normal baseline mental status with a recovered serum creatinine level of 0.68 mg/dL. We feel that awareness of this pathology remains a challenge for physicians and therefore strongly recommend the further accumulation of experiences similar to our own. Our experience underscores the pitfalls of administering valacyclovir to elderly patients who barely appear to have a favorable renal function. Several concerns regarding the therapeutic management, including blood purification strategies, that emerged in this case are also discussed.