Efavirenz-induced urolithiasis.
We describe the first case of efavirenz-induced urolithiasis in a 47-year-old HIV-positive patient. Urinary obstruction led to pyelonephritis and septic shock, requiring emergency ureteral catheterisation. The subsequent clinical course was favourable, allowing the patient's discharge on day 5....
| Main Authors: | , , , |
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| Format: | Journal article |
| Language: | English |
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2006
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| _version_ | 1797072999434682368 |
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| author | Wirth, G Teuscher, J Graf, J Iselin, C |
| author_facet | Wirth, G Teuscher, J Graf, J Iselin, C |
| author_sort | Wirth, G |
| collection | OXFORD |
| description | We describe the first case of efavirenz-induced urolithiasis in a 47-year-old HIV-positive patient. Urinary obstruction led to pyelonephritis and septic shock, requiring emergency ureteral catheterisation. The subsequent clinical course was favourable, allowing the patient's discharge on day 5. A 7 mm, radio-translucent, non-crystalline, beige stone was extracted during catheterisation. Stone analysis by Fourier transform infrared spectrometry, liquid chromatography and mass spectrometry revealed a stone composed of efavirenz (EFV) metabolites M4, M5, M8 (as described by Mutlib et al. in 1999) and approximately 50% of unspecified proteins. EFV is a non-nucleoside reverse transcriptase inhibitor introduced to European markets in 1999. It is principally metabolised by cytochrome P450 3A4 and 2B6. Of the dose, 14-34% is excreted in the urine, 1% as unchanged drug. The patient had been taking 600 mg EFV per day for 3 years. As EFV-induced urolithiasis has not been reported so far, we would like to draw the attention of the medical community to this potentially severe complication. |
| first_indexed | 2024-03-06T23:15:47Z |
| format | Journal article |
| id | oxford-uuid:6714bbba-2c17-482e-90f8-1ac47c24f1d0 |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-06T23:15:47Z |
| publishDate | 2006 |
| record_format | dspace |
| spelling | oxford-uuid:6714bbba-2c17-482e-90f8-1ac47c24f1d02022-03-26T18:35:58ZEfavirenz-induced urolithiasis.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:6714bbba-2c17-482e-90f8-1ac47c24f1d0EnglishSymplectic Elements at Oxford2006Wirth, GTeuscher, JGraf, JIselin, CWe describe the first case of efavirenz-induced urolithiasis in a 47-year-old HIV-positive patient. Urinary obstruction led to pyelonephritis and septic shock, requiring emergency ureteral catheterisation. The subsequent clinical course was favourable, allowing the patient's discharge on day 5. A 7 mm, radio-translucent, non-crystalline, beige stone was extracted during catheterisation. Stone analysis by Fourier transform infrared spectrometry, liquid chromatography and mass spectrometry revealed a stone composed of efavirenz (EFV) metabolites M4, M5, M8 (as described by Mutlib et al. in 1999) and approximately 50% of unspecified proteins. EFV is a non-nucleoside reverse transcriptase inhibitor introduced to European markets in 1999. It is principally metabolised by cytochrome P450 3A4 and 2B6. Of the dose, 14-34% is excreted in the urine, 1% as unchanged drug. The patient had been taking 600 mg EFV per day for 3 years. As EFV-induced urolithiasis has not been reported so far, we would like to draw the attention of the medical community to this potentially severe complication. |
| spellingShingle | Wirth, G Teuscher, J Graf, J Iselin, C Efavirenz-induced urolithiasis. |
| title | Efavirenz-induced urolithiasis. |
| title_full | Efavirenz-induced urolithiasis. |
| title_fullStr | Efavirenz-induced urolithiasis. |
| title_full_unstemmed | Efavirenz-induced urolithiasis. |
| title_short | Efavirenz-induced urolithiasis. |
| title_sort | efavirenz induced urolithiasis |
| work_keys_str_mv | AT wirthg efavirenzinducedurolithiasis AT teuscherj efavirenzinducedurolithiasis AT grafj efavirenzinducedurolithiasis AT iselinc efavirenzinducedurolithiasis |