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 

作者机构：Kidney Disease Centerthe First Affiliated HospitalCollege of MedicineZhejiang UniversityKey Laboratory of Kidney Disease Prevention and Control TechnologyZhejiang Provincethe Third Grade Laboratory Under the National StateAdministration of Traditional Chinese MedicineHangzhou 310000Zhejiang ProvinceChina Department of NephrologyBeilun People's HospitalNingbo 315000Zhejiang ProvinceChina 

出 版 物：《World Journal of Clinical Cases》 (世界临床病例杂志)

年 卷 期：2019年第7卷第20期

页      面：3329-3334页

核心收录：

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

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 

主　　题：Chronic renal failure Peritoneal dialysis Acyclovir Valacyclovir Neurotoxicity Herpes zoster Case report 

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.