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Related Experiment Videos

Acyclovir-induced thrombotic microangiopathy.

R Goli1, K K Mukku1, S B R Devaraju1

  • 1Department of Nephrology, Nizam's Institute of Medical Sciences, Hyderabad, Telangana, India.

Indian Journal of Nephrology
|March 31, 2017
PubMed
Summary
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Acyclovir can cause acute kidney injury (AKI) through crystal formation. This case report details AKI mimicking thrombotic microangiopathy, with partial recovery after plasmapheresis.

Area of Science:

  • Nephrology
  • Pharmacology
  • Virology

Background:

  • Acyclovir is a widely prescribed antiviral medication.
  • Acute kidney injury (AKI) from acyclovir is typically associated with intratubular crystal precipitation and interstitial nephritis.
  • Thrombotic microangiopathy is a serious condition characterized by microangiopathic hemolytic anemia, thrombocytopenia, and organ damage.

Observation:

  • A 61-year-old male with herpes zoster developed AKI.
  • The patient's presentation mimicked thrombotic microangiopathy.
  • Renal biopsy revealed acute interstitial nephritis.

Findings:

  • This case highlights acyclovir-induced AKI presenting atypically as thrombotic microangiopathy.
  • It is the first reported instance of acyclovir causing thrombotic microangiopathy.
Keywords:
Acute kidney injuryacyclovirthrombotic microangiopathy

Related Experiment Videos

  • Partial improvement in renal function was observed following plasmapheresis treatment.

    • Implications:

    • Clinicians should consider acyclovir as a potential cause of AKI, even with atypical presentations like thrombotic microangiopathy.
    • Early recognition and intervention, potentially including plasmapheresis, may improve outcomes.
    • This case expands the known spectrum of renal adverse effects associated with acyclovir therapy.