Efavirenz-induced urolithiasis
| Autor: | Juerg Teuscher, Christophe Iselin, Jean-Daniel Graf, Grégory Johann Wirth |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
Nephrology
Cyclopropanes Male medicine.medical_specialty Efavirenz Anti-HIV Agents Urology Urine chemistry.chemical_compound Urolithiasis Internal medicine Oxazines medicine Humans Adverse effect Oxazines/adverse effects/metabolism ddc:617 CYP3A4 Reverse-transcriptase inhibitor Pyelonephritis business.industry Septic shock Anti-HIV Agents/adverse effects/metabolism Clinical course Urinary Calculi/chemically induced/chemistry/complications Middle Aged medicine.disease Surgery Benzoxazines chemistry Pyelonephritis/etiology Alkynes Urinary Calculi business medicine.drug |
| Zdroj: | Urological Research, Vol. 34, No 4 (2006) pp. 288-9 |
| ISSN: | 0300-5623 |
| Popis: | We describe the first case of efavirenz-induced urolithiasis in a 47-year-old HIV-positive patient. Urinary obstruction led to pyelonephritis and septic shock, requiring emergency ureteral catheterisation. The subsequent clinical course was favourable, allowing the patient's discharge on day 5. A 7 mm, radio-translucent, non-crystalline, beige stone was extracted during catheterisation. Stone analysis by Fourier transform infrared spectrometry, liquid chromatography and mass spectrometry revealed a stone composed of efavirenz (EFV) metabolites M4, M5, M8 (as described by Mutlib et al. in 1999) and approximately 50% of unspecified proteins. EFV is a non-nucleoside reverse transcriptase inhibitor introduced to European markets in 1999. It is principally metabolised by cytochrome P450 3A4 and 2B6. Of the dose, 14-34% is excreted in the urine, 1% as unchanged drug. The patient had been taking 600 mg EFV per day for 3 years. As EFV-induced urolithiasis has not been reported so far, we would like to draw the attention of the medical community to this potentially severe complication. |
| Databáze: | OpenAIRE |
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