title: Metronidazole Toxicity in Cockayne Syndrome: A Case Series.
abstract: Cockayne syndrome (CS) is a rare genetic disorder characterized by small stature, intellectual disability, and accelerated pathologic aging. Through the Cockayne Syndrome Natural History Study, we have identified 8 cases of acute hepatic failure after metronidazole administration (8% of our cohort), 3 of which were fatal. The interval between initial administration and death was 6 to 11 days. Two of these patients also experienced acute neurologic deficit. Both hepatotoxicity and acute neurologic deficit have been reported previously as extremely rare adverse events after metronidazole administration. However, we have not identified any patients with CS who have received metronidazole without serious adverse effects. We recommend that a diagnosis of CS be considered an absolute contraindication to the use of metronidazole.
authors: Northern Genetics Service, Newcastle Upon Tyne NHS Foundation Trust, and Institute of Genetic Medicine, Newcastle University, International Centre for Life, Newcastle Upon Tyne, United Kingdom; and brian.wilson@ncl.ac.uk.
authors: Brian T
authors: BT
authors: Wilson
authors: Institute of Genetic Medicine, Newcastle University, International Centre for Life, Newcastle Upon Tyne, United Kingdom; and.
authors: Andrew
authors: A
authors: Strong
authors: Institute of Genetic Medicine, Newcastle University, International Centre for Life, Newcastle Upon Tyne, United Kingdom; and.
authors: Sean
authors: S
authors: O'Kelly
authors: Institute of Genetic Medicine, Newcastle University, International Centre for Life, Newcastle Upon Tyne, United Kingdom; and.
authors: Jennifer
authors: J
authors: Munkley
authors: Victorian Clinical Genetics Services, Murdoch Childrens Research Institute, Melbourne, Australia.
authors: Zornitza
authors: Z
authors: Stark
mesh_terms: D000293:Adolescent; D000890:Anti-Infective Agents / Q000009:adverse effects*; D003057:Cockayne Syndrome / Q000150:complications*; D017809:Fatal Outcome; D005260:Female; D005767:Gastrointestinal Diseases / Q000188:drug therapy; D006801:Humans; D007223:Infant; D007239:Infections / Q000188:drug therapy; D017114:Liver Failure, Acute / Q000139:chemically induced*; D008297:Male; D008795:Metronidazole / Q000009:adverse effects*; D020521:Stroke / Q000209:etiology; D055815:Young Adult
chemical_list: D000890:Anti-Infective Agents; D008795:Metronidazole