Neurologic sequelae associated with foscarnet therapy.
OBJECTIVE
To report three cases of possible foscarnet-induced neurologic sequelae.


METHODS
We report two cases of seizures and one case of hand cramping and finger paresthesia after starting foscarnet therapy with no evidence of predisposing risk factors, such as serum laboratory abnormalities, renal dysfunction, or known central nervous system (CNS) involvement. All three patients had stable laboratory values during therapy and when the neurologic adverse effects occurred. All patients were receiving appropriate dosages of foscarnet.


CONCLUSIONS
The incidence of seizures in AIDS patients was reviewed. A history of CNS lesions, infections, and/or AIDS per se may increase the risk of a neurologic adverse effect while receiving foscarnet therapy. Acute ionized hypocalcemia may cause these neurologic adverse effects. Ionized hypocalcemia is transitory, is related to the rate of foscarnet infusion, and may not be reflected as a change in total serum calcium concentration.


CONCLUSIONS
Foscarnet probably contributed to the neurologic adverse effects reported here. Foscarnet may need to be administered at a slower rate than is recommended by the manufacturer. Electrolytes must be monitored closely; however, a neurologic adverse effect may not be foreseen.
Lor
E
E
San Francisco General Hospital, CA 94110.
Liu
Y Q
YQ
D000163:Acquired Immunodeficiency Syndrome / Q000150:complications*; D000328:Adult; D017245:Foscarnet / Q000008:administration & dosage / Q000009:adverse effects*; D006225:Hand; D006801:Humans; D007262:Infusions, Intravenous / Q000009:adverse effects; D008297:Male; D009120:Muscle Cramp / Q000139:chemically induced; D010292:Paresthesia / Q000139:chemically induced; D011020:Pneumonia, Pneumocystis / Q000150:complications; D012640:Seizures / Q000139:chemically induced*
D017245:Foscarnet