Acute renal injury induced by valacyclovir hydrochloride: A case report

Abstract

Acyclovir has been a frequently used antiviral agent in the clinical treatment of leukemia, acute encephalitis, malignant tumor and herpes simplex. The adverse effects of this drug have been widely described in clinical practice. In the present study, a case of a 35-year-old female patient diagnosed with herpes simplex, who developed acute renal injury following treatment with valacyclovir hydrochloride, is described. Kidney biopsy, light microscopy and laboratory examination were performed, and all findings revealed the signs of evident vacuolar degeneration of capillary endothelial and renal tubular epithelial cells, erythrocyte aggregation in partial renal tubule and microvilli exfoliation from epithelial cells. Renal interstitial edema was clearly identified. The clinical evidence observed from this female patient indicated that renal functions should be closely monitored during valacyclovir hydrochloride administration. A variety of effective measures, such as hydration, alkalizing urine, promoting the discharge of medication and the use of antagonists are recommended following the administration of antiviral agents.

Keywords: acute renal injury; acyclovir; adverse event; herpes simples.

Figure 1.

Electron microscopy of the patient's kidney.

Figure 2.

Pathological examination. (A) Hematoxylin and eosin staining revealing partial lumen ectasia and microvilli exfoliation from epithelial cells (magnification, ×400). (B and C) PAS revealing slight hyperplasia of glomeruli mesangial cell and matrix (magnification, ×400); (D) Periodic Schiff-Methenamine Silver revealing opening of the capillary loop and no apparent basement membrane thicknening (magnification, ×400).