Reversible brain MRI changes in acyclovir neurotoxicity.
This case report shows reversible brain MRI changes probably associated with acyclovir toxicity. So far, neuroimaging in acyclovir toxicity had been negative or uninformative. A 12-year-old girl developed focal secondary generalizing epileptic fits following 4 weeks of prophylactic administration of acyclovir (3 x 10 mg/kg body weight/day i.v.) on day +22 after allogeneic peripheral blood stem cell transplantation for CML. Infective causes were excluded. Brain MRI demonstrated multiple gadolinium-enhancing areas with impairment of the blood-brain barrier in cortical and subcortical regions. Clinical symptoms and neuroimaging pathology resolved completely within 9 days of acyclovir withdrawal.
Blohm
M E
ME
Department of Paediatric Haematology and Oncology, Heinrich Heine University Medical Centre, Dusseldorf, Germany.
Nürnberger
W
W
Aulich
A
A
Engelbrecht
V
V
Burdach
S
S
D000212:Acyclovir / Q000009:adverse effects* / Q000097:blood; D000998:Antiviral Agents / Q000009:adverse effects* / Q000097:blood; D001812:Blood-Brain Barrier / Q000187:drug effects; D001921:Brain / Q000187:drug effects* / Q000473:pathology* / Q000503:physiopathology; D002648:Child; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000628:therapy; D008279:Magnetic Resonance Imaging
D000998:Antiviral Agents; D000212:Acyclovir