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VOLUME 19 , ISSUE 3 ( 2015 ) > List of Articles

CASE REPORT

Fatal lactic acidosis possibly related to ganciclovir therapy in a renal transplant patient?

Xavier Wittebole, Johann Morelle, Marie-Françoise Vincent, Philippe Hantson

Keywords : Ganciclovir, lactic acidosis, renal transplant

Citation Information : Wittebole X, Morelle J, Vincent M, Hantson P. Fatal lactic acidosis possibly related to ganciclovir therapy in a renal transplant patient?. Indian J Crit Care Med 2015; 19 (3):177-179.

DOI: 10.4103/0972-5229.152772

License: CC BY-ND 3.0

Published Online: 01-03-2015

Copyright Statement:  Copyright © 2015; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Ganciclovir is widely prescribed in renal transplant patients for the prevention or treatment of herpes and cytomegalovirus (CMV) infections. Side-effects are usually represented by hematological disorders, and particularly leucopenia. We report a case of severe and fatal lactic acidosis developing in a 76-year-old renal transplant woman, a few days after ganciclovir has been introduced to treat CMV pneumonia. Usual etiologies of lactic acidosis were ruled out. A high lactate/pyruvate molecular ratio was suggestive of a respiratory chain dysfunction. With the analogy to nucleoside analogues-related lactic acidosis, we suggest that ganciclovir may exceptionally be responsible for respiratory chain dysfunction and subsequent lactic acidosis, and we discuss potential risk factors in our patient.


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