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[Piperazine intoxication in long-term hemodialysis]
Schweizerische Medizinische Wochenschrift
|February 4, 1978
Summary
Piperazine treatment for pinworms can cause severe neurological symptoms in patients with kidney failure. Discontinuation of piperazine and hemodialysis led to symptom resolution, highlighting contraindication in renal impairment.
Area of Science:
- Neurology
- Pharmacology
- Nephrology
Background:
- Piperazine is an anthelmintic medication used to treat parasitic worm infections like oxyuriasis.
- Patients with renal failure are at increased risk for drug toxicity due to impaired excretion.
- Dialysis dementia is a serious neurological complication associated with chronic kidney disease and dialysis.
Observation:
- A 35-year-old patient with end-stage renal failure received piperazine hexahydrate for oxyuriasis.
- The patient developed severe neurological symptoms including precoma, dysarthria, apraxia, spasms, tremor, and cognitive impairment.
- Electroencephalogram (EEG) revealed diffuse, multifocal delta wave disturbances.
Findings:
- Piperazine therapy in a patient with renal failure precipitated a neurotoxic syndrome mimicking dialysis dementia.
- Symptoms significantly improved within a week after discontinuing piperazine and initiating maintenance hemodialysis.
- The patient's neurological status returned to baseline following treatment cessation and supportive care.
Implications:
- Piperazine is contraindicated in patients with renal failure due to the high risk of severe neurotoxicity.
- This case underscores the importance of careful drug selection and monitoring in patients with impaired renal function.
- Nephrologists and neurologists should be aware of piperazine's potential adverse effects in renally compromised individuals.