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Intravascular foscarnet crystal precipitation causing multiorgan failure
Carole Philipponnet1, Pierre-Antoine Michel2, Michel Daudon3
1Nephrology Department, Tenon Hospital, AP-HP, Paris; Nephrology Department, Clermont Ferrand, University Hospital, Clermont-Ferrand, Paris, France; Faculty of Medicine, University Clermont 1, Clermont-Ferrand, Paris, France.
Summary
Foscarnet antiviral treatment caused multiorgan failure in a kidney transplant patient due to crystal precipitation. Promptly stopping foscarnet improved the patient, but the kidney transplant was permanently lost.
Area of Science:
- Nephrology
- Virology
- Pathology
Background:
- Kidney transplant recipients often require antiviral therapy.
- Foscarnet is a commonly used antiviral agent.
- Multiorgan failure is a serious potential complication in transplant patients.
Observation:
- A kidney transplant recipient developed multiorgan failure during foscarnet treatment.
- Histological examination of a kidney biopsy revealed foscarnet crystal precipitation.
- The patient exhibited pancreatitis, pancolitis, and myocarditis with shock.
Findings:
- Foscarnet crystal deposition in renal tubules and capillaries caused kidney damage.
- The patient experienced severe systemic complications beyond kidney injury.
- Discontinuation of foscarnet led to clinical improvement but not graft survival.
Implications:
- Foscarnet should be considered a potential cause of unexplained multiorgan failure in treated patients.
- Kidney biopsy is a valuable diagnostic tool for foscarnet-induced toxicity.
- Early recognition and intervention are crucial for managing foscarnet-related complications in transplant recipients.
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