title: Acute Renal Injury Induced by Hypersensitivity to Tolvaptan in an Elderly Patient with Congestive Heart Failure.
abstract: Tolvaptan (TLV) is a new vasopressin type 2 receptor antagonist effective in patients with heart failure (HF). We herein describe the case of an 84-year-old woman who developed acute renal injury induced by hypersensitivity to TLV. The patient had received an implanted pacemaker and was diagnosed with exacerbation of chronic HF due to atrial fibrillation, mitral regurgitation, tricuspid regurgitation and left ventricular dyssynchrony. Treatment with tolvaptan increased the urine volume, improved the dyspnea and decreased the edema. However, the patient's renal function and hyperkalemia worsened, and the blood eosinophil count increased without signs of dehydration or hypotension. Positive findings on a drug-induced lymphocyte stimulation test for TLV were consistent with this diagnosis.
authors.affiliation: Division of Circulatory and Body Fluid Regulation, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki, 2. Department  of Cardiology, Miyazaki Prefectural Nichinan Hospital, Japan.
authors.forename: Masashi
authors.initials: M
authors.lastname: Yamaguchi
authors.forename: Kensaku
authors.initials: K
authors.lastname: Nishihira
authors.forename: Takayuki
authors.initials: T
authors.lastname: Okubo
authors.forename: Yujiro
authors.initials: Y
authors.lastname: Asada
authors.forename: Kazuo
authors.initials: K
authors.lastname: Kitamura
mesh_terms: D058186:Acute Kidney Injury / Q000209:etiology*; D000369:Aged, 80 and over; D065092:Antidiuretic Hormone Receptor Antagonists / Q000009:adverse effects* / Q000627:therapeutic use; D001552:Benzazepines / Q000009:adverse effects* / Q000627:therapeutic use; D001794:Blood Pressure / Q000187:drug effects; D004342:Drug Hypersensitivity / Q000209:etiology*; D005260:Female; D006333:Heart Failure / Q000188:drug therapy*; D006801:Humans; D017483:Receptors, Vasopressin; D000077602:Tolvaptan
chemical_list: D065092:Antidiuretic Hormone Receptor Antagonists; D001552:Benzazepines; D017483:Receptors, Vasopressin; D000077602:Tolvaptan