Reactions 1704, p14 - 2 Jun 2018 Aciclovir/ etanercept/hydroxychloroquine Disseminated cutaneous herpes zoster and acute renal failure: case report A 75-year-old woman developed disseminated cutaneous herpes zoster infection during treatment with etanercept and hydroxychloroquine for rheumatoid arthritis. Additionally, she developed acute renal failure during treatment with aciclovir for disseminated cutaneous herpes zoster infection [dosages and durations of treatments to reactions onsets not stated; not all routes stated]. The woman, who was receiving treatment with etanercept and hydroxychloroquine for rheumatoid arthritis, presented to the emergency department due to generalised body pain and widespread rash. She reported that the skin lesions initially erupting on her buttocks and scalp and then spread to her back and chest. On examination, she demonstrated a large group of erythematous vesicles following the S1 dermatome and numerous pox-like lesions scattered throughout the buccal mucosa, palate, scalp, face, chest and back. Due to her immunocompromised state and widespread vesicular lesions, her clinical presentation was concerning for disseminated cutaneous herpes zoster. The woman was hospitalised for IV antiviral therapy with aciclovir and both hydroxychloroquine and etanercept were discontinued. She responded well to aciclovir therapy. However, she developed acute renal failure secondary to aciclovir, with creatinine level of 2.6 mg/dL from baseline 0.8 mg/dL. She was then transitioned to famciclovir and aggressively hydrated with IV fluids. Her lesions had crusted over throughout 5–6 days of the admission without further complication. She was continued on famciclovir for a total of 10 days. At the time of discharge, she had a normal renal function. She was to address continuation of her immunosuppressant therapy with her rheumatologist that likely contributed to the severity of infection. Author comment: "[Disease-modifying antirheumatic drugs] and corticosteroids are associated with an increased risk of developing herpes zoster and disseminated cutaneous and visceral involvement." "She responded well to antiviral treatment, however, developed acute renal failure with creatinine spiking to 2.6 mg/dL from baseline 0.8 mg/dL, secondary to acyclovir." Bucci L, et al. Disseminated herpes zoster in the geriatric immunocompromised patient. Journal of the American Geriatrics Society 66 (Suppl. 2): S261-S262, Jan 2018. Available from: URL: http://doi.org/10.1111/jgs.15376 [abstract] - USA 803323428 0114-9954/18/1704-0001/$14.95 Adis © 2018 Springer International Publishing AG. All rights reserved Reactions 2 Jun 2018 No. 1704
Reactions Weekly – Springer Journals
Published: Jun 2, 2018
It’s your single place to instantly
discover and read the research
that matters to you.
Enjoy affordable access to
over 18 million articles from more than
15,000 peer-reviewed journals.
All for just $49/month
Query the DeepDyve database, plus search all of PubMed and Google Scholar seamlessly
Save any article or search result from DeepDyve, PubMed, and Google Scholar... all in one place.
Get unlimited, online access to over 18 million full-text articles from more than 15,000 scientific journals.
Read from thousands of the leading scholarly journals from SpringerNature, Elsevier, Wiley-Blackwell, Oxford University Press and more.
All the latest content is available, no embargo periods.
“Hi guys, I cannot tell you how much I love this resource. Incredible. I really believe you've hit the nail on the head with this site in regards to solving the research-purchase issue.”Daniel C.
“Whoa! It’s like Spotify but for academic articles.”@Phil_Robichaud
“I must say, @deepdyve is a fabulous solution to the independent researcher's problem of #access to #information.”@deepthiw
“My last article couldn't be possible without the platform @deepdyve that makes journal papers cheaper.”@JoseServera