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Valacyclovir-associated acute kidney injury and encephalopathy in an elderly woman with normal kidney function: a case report
CEN Case Rep. 2022 Nov 18. doi: 10.1007/s13730-022-00748-5. Online ahead of print.ABSTRACTA 72-year-old Japanese woman was treated by 3000 mg/day of valacyclovir for the herpes zoster in her left back. She had been treated as hypertension with no renal insufficiency. In two days, she visited an emergency room of a regional stroke care center with dysarthria, dexterity disorder and gait disturbance. Neither head CT nor MRI found intracranial lesions, then, laboratory tests revealed that her serum creatinine level was 4.63 mg/dL. She was transferred and admitted to our hospital on the following day and received hemodialysis ...
Source: Herpes - November 18, 2022 Category: Infectious Diseases Authors: Kazufumi Kato Reiichi Murakami Hiroshi Shiroto Daiki Nagawa Ikuyo Narita-Kinjo Takeshi Fujita Michiko Shimada Hirofumi Tomita Source Type: research

266 A drowsy patient: beyond the familiar territory
A 72-year-old man was brought to the hospital after he was found unresponsive at home by his wife who reported that he has been sleepy in the last few days. He has a background of hypertension, myocardial infarct, and osteoarthritis. His medications include anti-hypertensive and morphine sulphate. On examination, he was drowsy with GCS fluctuating between 9–11 but maintaining his airways. He was moving all four limbs; pupils were small and unequal but reactive to light. Planter reflexes were downgoing. Opioid toxicity was suspected and treated with naloxone without any response. The CT head scan showed no acute patho...
Source: Journal of Neurology, Neurosurgery and Psychiatry - May 27, 2022 Category: Neurosurgery Authors: Oo, A., Khine, N. Tags: Poster Presentations Source Type: research

Mitochondrial A3243G mutation causes mitochondrial encephalomyopathy in a Chinese patient: Case report
Rationale: Mitochondrial mutations are associated with a wide spectrum of clinical abnormalities. More than half of these mutations are distributed in the 22 mitochondrial tRNA genes, including tRNALeu(UUR). In particular, the A3243G mutation in the tRNALeu(UUR) gene causes mitochondrial encephalomyopathy. Patient concerns: A 12-year-old boy was admitted to Shaoxing People's Hospital because there is a reduction in the volume of speech, dysphonia, unable to write, recognize words, and unable to wear clothes, accompanied by unstable walking after treatment of unexplained fever and somnolence. Diagnoses: The proband ...
Source: Medicine - May 1, 2019 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Don’t shrug off shingles
If you had chickenpox as a kid, there is a good chance you may develop shingles later in life. “In fact, one in three is predicted to get shingles during their lifetime,” says Dr. Anne Louise Oaklander, director of the Nerve Unit at Harvard-affiliated Massachusetts General Hospital. The same varicella-zoster virus that causes chickenpox also causes shingles. After the telltale spots of chickenpox vanish, the virus lies dormant in your nerve cells near the spinal cord and brain. When your immunity weakens from normal aging or from illnesses or medications, the virus can re-emerge. It then travels along a nerve to trigge...
Source: New Harvard Health Information - February 18, 2016 Category: Consumer Health News Authors: Matthew Solan Tags: Healthy Aging Infectious diseases Vaccines Source Type: news

Valacyclovir and Acyclovir Neurotoxicity With Status Epilepticus
We present the case of a 52-year-old man with hypertension, diastolic congestive heart failure, end-stage renal disease on hemodialysis 3 times a week and a remote history of a hemorrhagic stroke who presented to the emergency department with a vesicular rash on his left arm. The rash was observed to be in a dermatomal distribution, and a diagnosis of herpes zoster was made. The patient was discharged home on valacyclovir 1 g 3 times a day for a duration of 7 days. The patient took 2 doses of valacyclovir before presenting to the hospital again with irritability and hallucinations. Over the next several days, the patient's...
Source: American Journal of Therapeutics - January 1, 2016 Category: Drugs & Pharmacology Tags: Case Reports Source Type: research

Anti glutamic acid decarboxylase antibody mediated encephalopathy while on etanercept in a patient with multiple autoimmune diseases
A 39 year old lady presented with an altered mental state and unsteadiness of gait. She had a history of juvenile idiopathic arthritis, autoimmune thyroiditis and alopecia, protein S deficiency with vena cava thrombosis, previous excision of ovarian mass and vasculitic rash. There was a previous history of ovarian mass and her immunomodulatory therapy for arthritis over the previous year was Etanercept. She used recreational cannabis but denied any other illicit drug usage. Her affect was variable and at times inappropriate with frequent laughter. She would spit regularly. There was anxiety and a prevailing sensation of do...
Source: Journal of Neurology, Neurosurgery and Psychiatry - October 9, 2013 Category: Neurosurgery Authors: MacDougall, N., Waddell, B., O'Riordan, J. I. Tags: Immunology (including allergy), Brain stem / cerebellum, Drugs: CNS (not psychiatric), Epilepsy and seizures, Infection (neurology), Stroke, Drugs misuse (including addiction), Connective tissue disease, Musculoskeletal syndromes Association of British Source Type: research