ABSTRACT
Well-known side effects of acyclovir are nephrotoxicity and neurotoxicity. We present a 49-year-old woman without pre-existing renal failure, with an acute kidney injury and encephalopathy. Since there was a clear correlation with the intake of acyclovir and the course of illness, findings were attributed to the antiviral agent. Urinalysis showed a proteinuria in nephrotic ranges, which is not described in the currently known causes of acyclovir-induced renal failure. We postulate the hypothesis of a nephritis with podocyte damage induced by acyclovir or, more likely, by an acyclovir metabolite. LEARNING POINTS: Presentation of a case of acute kidney injury, with haematuria and proteinuria in nephrotic ranges, after acyclovir administration. These findings suggest glomerular involvement; we postulate a hypothesis of a nephritis with podocyte damage.Observation of associated mild encephalopathy in a patient without pre-existing kidney failure.Toxic mechanism of glomerular damage and combined encephalopathy. This should be further investigated.
