BACKGROUND: Ganciclovir, a drug against cytomegalovirus (CMV) infection, is generally well tolerated, but can cause neurotoxicity such as encephalopathy. Although ganciclovir-induced encephalopathy has been described in several reports, a literature search revealed that ganciclovir concentrations in the blood or cerebrospinal fluid were previously measured in only 3 patients with encephalopathy.
Symptoms usually include confusion and disturbed consciousness, which mimic CMV encephalitis. Prompt and accurate diagnosis is thus sometimes difficult, and is derived solely from accumulated clinical information of definite cases, since ganciclovir concentrations, not routinely measured, become available after several days or a few weeks.
CASE PRESENTATION: Here, we summarize clinical information of all patients with definite ganciclovir-induced encephalopathy including our own patient, who had severe symptoms, with the highest reported trough concentration of ganciclovir in the blood, and underwent therapeutic dialysis with complete recovery.
CONCLUSION: Our summary of patients with definite encephalopathy could lead to prompt and accurate diagnoses.
Written by:
Sakamoto H1, Hirano M2, Nose K3, Ueno S1, Oki T3, Sugimoto K3, Nishioka T3, Kusunoki S4, Nakamura Y1 Are you the author?
1Department of Neurology, Sakai Hospital Kinki University Faculty of Medicine, Sakai, Osakasayama, Japan. 2Department of Neurology, Sakai Hospital Kinki University Faculty of Medicine, Sakai, Osakasayama, Japan ; Department of Department of Neurology, Kinki University Faculty of Medicine, Osakasayama, Japan. 3Department of Urology, Sakai Hospital Kinki University Faculty of Medicine, Sakai, Osakasayama, Japan. 4Department of Department of Neurology, Kinki University Faculty of Medicine, Osakasayama, Japan.
Reference: Case Rep Neurol. 2013 Oct 5;5(3):183-6. eCollection 2013
doi: 10.1159/000355638
PubMed Abstract
PMID: 24403897
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