title: A case report of acute renal failure and fulminant hepatitis associated with edaravone administration in a cerebral infarction patient.
abstract: A 60-year-old male with cerebral infarction was admitted to our hospital and treated with edaravone. On day 12 of hospitalization, he suddenly lost consciousness and went into shock. Based on the laboratory findings, acute renal failure (ARF), fulminant hepatitis, and disseminated intravascular coagulation (DIC) were diagnosed. We immediately initiated continuous hemodiafiltration for three days and performed three sessions of plasma exchange. Following this, a gradual improvement was observed in the patient's general condition and laboratory values. On day 17 of hospitalization, intermittent hemodialysis (HD) was initiated. On day 20 of hospitalization, his renal function started to improve with an increase in urine volume. HD was successfully discontinued on the same day. Although the drug lymphocyte stimulation test for edaravone was negative, edaravone-induced fulminant hepatitis was suggested based on liver biopsy findings. We present a case of ARF, fulminant hepatitis, and DIC due to edaravone administration that was successfully treated with blood purification techniques. Since the use of edaravone treatment is expected to increase in the future, it is essential that clinicians consider the potential adverse effects of this treatment. It is suggested that blood purification is effective in inducing remission in patients with complications due to edaravone treatment.
authors.affiliation: Department of Medicine, Division of Nephrology and Endocrinology, Nihon University, School of Medicine, Tokyo, Japan. m_nori71@yahoo.co.jp
authors.forename: Masanori
authors.initials: M
authors.lastname: Abe
authors.forename: Kazo
authors.initials: K
authors.lastname: Kaizu
authors.forename: Koichi
authors.initials: K
authors.lastname: Matsumoto
mesh_terms: D058186:Acute Kidney Injury / Q000139:chemically induced* / Q000628:therapy; D000983:Antipyrine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*; D002544:Cerebral Infarction / Q000503:physiopathology*; D004211:Disseminated Intravascular Coagulation / Q000175:diagnosis* / Q000628:therapy; D000077553:Edaravone; D016166:Free Radical Scavengers / Q000008:administration & dosage* / Q000009:adverse effects*; D006505:Hepatitis / Q000175:diagnosis / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010951:Plasma Exchange; D006435:Renal Dialysis
chemical_list: D016166:Free Radical Scavengers; D000077553:Edaravone; D000983:Antipyrine