title: [Salt-wasting nephropathy induced by foscarnet treatment for HHV-6 encephalitis in a hematopoietic stem cell transplant].
abstract: A 51-year-old woman with myelodysplastic syndrome developed HHV-6 encephalitis on day 34 after unrelated bone marrow transplantation. Although prompt treatment with foscarnet stabilized encephalitis and there were no serious neurological sequelae, the patient developed both hyponatremia and natriuresis 11 days after intravenous administration of foscarnet. Subsequent investigation demonstrated hyponatremia due to salt-wasting nephropathy induced by foscarnet. Discontinuation of foscarnet and fluid replacement therapy with adequate sodium chloride (NaCl) resulted in a gradual resolution of hyponatremia and natriuresis. Currently, 8 months after these clinical events, the patient is under outpatient treatment for persistent nephropathy that requires small amounts of oral NaCl supplement, but she is otherwise in good clinical condition.
authors.affiliation: Hematology Division, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo.
authors.forename: Yuho
authors.initials: Y
authors.lastname: Najima
authors.forename: Kazuteru
authors.initials: K
authors.lastname: Ohashi
authors.forename: Minoru
authors.initials: M
authors.lastname: Ando
authors.forename: Akira
authors.initials: A
authors.lastname: Koshida
authors.forename: Takuya
authors.initials: T
authors.lastname: Yamashita
authors.forename: Hideki
authors.initials: H
authors.lastname: Akiyama
authors.forename: Hisashi
authors.initials: H
authors.lastname: Sakamaki
mesh_terms: D000998:Antiviral Agents / Q000009:adverse effects*; D018792:Encephalitis, Viral / Q000188:drug therapy* / Q000209:etiology*; D005260:Female; D017245:Foscarnet / Q000009:adverse effects*; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D015654:Herpesvirus 6, Human; D006801:Humans; D007010:Hyponatremia / Q000139:chemically induced*; D007674:Kidney Diseases / Q000139:chemically induced* / Q000378:metabolism; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000150:complications / Q000628:therapy*; D019349:Roseolovirus Infections / Q000188:drug therapy* / Q000209:etiology*; D012965:Sodium Chloride / Q000378:metabolism
chemical_list: D000998:Antiviral Agents; D017245:Foscarnet; D012965:Sodium Chloride