阿昔洛韦过量致急性肾衰竭

例19岁男性传染性单核细胞增多症患者拟给予阿昔洛韦600 mg加入10%葡萄糖注射液250 ml中静脉滴注.但因用药错误将阿昔洛韦3.0 g加入10%葡萄糖注射液250 ml中静脉滴注.输注完毕后9 h,患者出现明显腰痛,尿量减少,尿蛋白(+ +),尿潜血(+ +).随后出现24 h无尿.第3天肾功能检查:血清肌酐557 μmol/L,尿素9.2 mmol/L.肾脏超声示双肾弥漫性病变.行血液净化,并给予甲泼尼龙40 mg/d静脉滴注,治疗2 d.肾功能逐渐好转,尿量增多.第15天患者肾功能及尿常规检查均无异常,痊愈出院.

Acute renal failure due to aciclovir overdose

A 19-year-old man with infectious mononucleosis was prescribed an IV infusion of aciclovir 600 mg in 10% glucose 250 ml but,due to a medication error,he received an IV infusion of aciclovir 3.0 g in 10% glucose 250 ml.Nine hours after infusion completion,he developed marked lumbago,oliguria,2＋ urine protein,and 2＋ urine occult blood followed by a 24-hour anuria period.On day 3,his renal function tests revealed a serum creatinine level of 557 μmol/L and a urea level of 9.2 mmol/L.Renal ultrasonography showed diffuse bilateral renal lesion.He received blood purification and an IV infusion of methylprednisolone 40 mg/d for 2 days.His renal function improved and urine volume increased.On day 15,both his renal function and routine urine tests returned to normal and he was discharged with complete recovery.