Aciclovir/etanercept/hydroxychloroquine

Aciclovir/etanercept/hydroxychloroquine 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 http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Reactions Weekly Springer Journals

Aciclovir/etanercept/hydroxychloroquine

Reactions Weekly , Volume 1704 (1) – Jun 2, 2018
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Publisher
Springer Journals
Copyright
Copyright © 2018 by Springer International Publishing AG, part of Springer Nature
Subject
Medicine & Public Health; Drug Safety and Pharmacovigilance; Pharmacology/Toxicology
ISSN
0114-9954
eISSN
1179-2051
D.O.I.
10.1007/s40278-018-46657-7
Publisher site
See Article on Publisher Site

Abstract

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

Journal

Reactions WeeklySpringer Journals

Published: Jun 2, 2018

References

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