Severe mental disorders following anti-retroviral treatment in a patient on peritoneal dialysis: A case report and literature review  

作　　者：Qi-En He Min Xia Guang-Hui Ying Xue-Lin He Jiang-Hua Chen Yi Yang 

机构地区：[1]Kidney Disease Center,the First Affiliated Hospital,College of Medicine,Zhejiang University,Key Laboratory of Kidney Disease Prevention and Control Technology,Zhejiang Province,the Third Grade Laboratory Under the National State,Administration of Traditional Chinese Medicine,Hangzhou 310000,Zhejiang Province,China [2]Department of Nephrology,Beilun People's Hospital,Ningbo 315000,Zhejiang Province,China

出　　处：《World Journal of Clinical Cases》2019年第20期3329-3334,共6页世界临床病例杂志

基　　金：Supported by the grant from the National Nature Science Foundation of China,No.81670621;the Nature Science Foundation of Zhejiang Province,No.LY16H050001

摘　　要：BACKGROUND Antiviral drugs are widely used in populations with viral infection caused by immunologic inadequacy.Because these drugs are mainly metabolized by the kidneys,patients with renal failure undergoing renal replacement therapy are prone to drug adverse effects and poisoning.Severe neurotoxicity caused by antiviral drugs is a rare but life-threatening complication.CASE SUMMARY This study reported one male patient on peritoneal dialysis who suffered from severe mental disorders after receiving an overdose of acyclovir and valacyclovir for the treatment of herpes zoster.The literature review suggested that hemodialysis is better than peritoneal dialysis to clear acyclovir from the circulation.The patient died after his consciousness deteriorated despite peritoneal dialysis and continuous blood purification.CONCLUSION This case emphasizes cautiousness when using anti-retroviral drugs in patients with uremia.Hemodialysis is optimal method to remove the drugs.BACKGROUND Antiviral drugs are widely used in populations with viral infection caused by immunologic inadequacy. Because these drugs are mainly metabolized by the kidneys, patients with renal failure undergoing renal replacement therapy are prone to drug adverse effects and poisoning. Severe neurotoxicity caused by antiviral drugs is a rare but life-threatening complication.CASE SUMMARY This study reported one male patient on peritoneal dialysis who suffered from severe mental disorders after receiving an overdose of acyclovir and valacyclovir for the treatment of herpes zoster. The literature review suggested that hemodialysis is better than peritoneal dialysis to clear acyclovir from the circulation. The patient died after his consciousness deteriorated despite peritoneal dialysis and continuous blood purification.CONCLUSION This case emphasizes cautiousness when using anti-retroviral drugs in patients with uremia. Hemodialysis is optimal method to remove the drugs.

关 键 词：Chronic renal failure PERITONEAL dialysis ACYCLOVIR VALACYCLOVIR NEUROTOXICITY HERPES ZOSTER Case report 

分 类 号：R73[医药卫生—肿瘤]