Cytomegalovirus (CMV) is a serious complication of immunosuppressed patients receiving bone marrow transplantation. Foscarnet, a pyrophosphate analog, has been used in the treatment of CMV infections. Renal impairment and electrolyte abnormalities are potential adverse reactions associated with the use of foscarnet. We report a case of significant electrolyte changes after initiation of foscarnet in a bone marrow transplant patient receiving parenteral nutrition. (Journal of Parenteral and Enteral Nutrition24:170-173, 2000)
Get full access to this article
View all access options for this article.
References
1.
Goodrich JM, Mori M., Gleaves CA, et al: Early treatment with ganciclovir to prevent cytomegalovirus disease after allogeneic bone marrow transplantation. New Engl J Med325:1601-1607. 1991
2.
Ljungman P., De Bock R., Cordonnier C., et al: Practices for cytomegalovirus diagnosis, prophylaxis and treatment in allogeneic bone marrow transplant recipients: A report from the Working Party for Infectious Disease of the EBMT. Bone Marrow Transplant12:399-403, 1993
3.
Chrisp P., Clissod P.: Foscarnet: A review of its antiviral activity, pharmacokinetic properties and therapeutic use in immunocompromised patients with cytomegalovirus retinitis . Drugs41:104-129, 1991
4.
Walmsley S., Chew E., Read S., et al: Treatment of cytomegalovirus retinitis with trisodium phosphonophormate hexahydrate (foscarnet). J Infect Dis157:569-572, 1988
5.
Klintmalm G. , Lonnqvist B., Oberg B., et al: Intravenous foscarnet for the treatment of sever cytomegalovirus infection in allograft recipients. Scand J Infect Dis17:157-163, 1985
6.
Reusser P., Gambertoglio J., Lilleby K., et al: Phase I-II trial of foscarnet for prevention of cytomegalovirus infection in autologous and allogeneic marrow transplant recipients. J Infect Dis166:473-479, 1992
7.
Bacigalupo A. , Tedone E., Van Lint MT, et al: CMV prophylaxis for foscarnet in allogeneic bone marrow transplant recipients at high risk of developing CMV infections . Bone Marrow Transplant13:783-788, 1994
8.
Ljungman P., Oberg G., Aschan J., et al: Foscarnet for pre-emptive therapy of CMV infection detected by a leukocyte-based nested PCR in allogeneic bone marrow transplant patients . Bone Marrow Transplant18:565-568, 1966
9.
Chang J., Powles R., Singhal S., et al: Foscarnet therapy for cytomegalovirus infection after allogeneic bone marrow transplantation. Clin Infect Dis22:583-584, 1996
10.
Studies of Ocular Complications of AIDS Research Group, in collaboration with the AIDS Clinical Trials Group.Mortality in patients with the acquired immunodeficiency syndrome treated with either foscarnet or ganciclovir for cytomegalovirus retinitis. N Engl J Med326:213-220, 1992
11.
Deray G., Martinez F., Katlama C., et al: Foscarnet nephrotoxicity : Mechanism, incidence and prevention . Am J Nephrol9:316-321, 1989
12.
Farese R. Jr, Schambelan M., Hollander H., et al: Nephrogenic diabetes insipidus associated with foscarnet treatment of cytomegalovirus retinitis. Ann Intern Med112:955-956, 1990
13.
Malin A., Miller R.: Foscarnet-induced hypokalemia. J Infect25:329-336, 1992
14.
Aschan J., Ringden O., Ljungman P., et al: Foscarnet for treatment of cytomegalovirus infection in bone marrow transplant recipients. Scand J Infect Dis24:143-150, 1992
15.
Wahren B., Oberg B.: Reversible inhibition of cytomegalovirus replication by phosphonoformate . Intervirology14:7-15, 1980
16.
Minor JR, Baltz JK: Foscarnet sodium. DICP Ann Pharmacother25:41-47, 1991
17.
Navarro JF, Carmen Q., Quereda C., et al: Nephrogenic diabetes insipidus and renal tubular acidosis secondary to foscarnet therapy. Am J Kidney Dis27:431-434, 1996
18.
Yusufi A., Szczepanska-Konkel M., Kempson S., et al: Inhibition of human renal epithelial Na-/Pi cotransport by phosphonoformic acid. Biochem Biophys Res Commun139:679-686, 1986
Jacobson MA , Gambertoglio JG, Aweeka FT, et al: Foscarnet-induced hypocalcemia and effects of foscarnet on calcium metabolism. J Clin Endocrinol Metab72:1130-1135, 1991
21.
Lor E., Liu YQ: Neurologic sequelae associated with foscarnet therapy. Ann Pharmacother28:1035-1037, 1994
22.
Castelli F. , Tomasoni L., Zeroli C., et al: Comparison of pharmacokinetics and dynamics of two dosage regiments of foscarnet in AIDS patients with cytomegalovirus retinitis. Eur J Clin Pharmacol52:397-401, 1997
Sjovall J., Bergdahl S., Movin G., et al: Pharmacokinetics of foscarnet and distribution to cerebrospinal fluid after intravenous infusion in patients with human immunodeficiency virus infection. Antimicrob Agents Chemother33:1023-1031, 1989
25.
Naik HR, Siddique N., Chandrasekar PH: Foscarnet therapy for acyclovir-resistant herpes simplex virus 1 infection in allogeneic bone marrow transplant recipients. Clin Infect Dis21:1514-1515, 1995
26.
Morales JM, Munoz MA, Fernandez Zatarain G., et al: Reversible acute renal failure caused by the combined used of foscarnet and cyclosporin in organ transplanted patients. Nephrol Dial Transplant10:882-883, 1995
27.
Palestine AG , Polis MA, DeSmet MD, et al: A randomized, controlled trial of foscarnet in the treatment of cytomegalovirus in patients with AIDS. Ann Intern Med115:665-673, 1991
28.
Gearhart MO , Sorg TB: Foscarnet-induced severe hypomagnesemia and other electrolyte disorders. Ann Pharmacother27:285-289, 1993
29.
Anast CS, Mohs JM, Kaplan SL, et al: Evidence for parathyroid failure in magnesium deficiency. Science177:606-608, 1972