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Efavirenz-induced urolithiasis

Published in Urological Research. 2006, vol. 34, no. 4, p. 288-9
Collection Open Access - Licence nationale Springer
Abstract 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.
Keywords Anti-HIV Agents/adverse effects/metabolismBenzoxazinesHumansMaleMiddle AgedOxazines/adverse effects/metabolismPyelonephritis/etiologyUrinary Calculi/chemically induced/chemistry/complications
PMID: 16625385
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Article (Published version) (229 Kb) - public document Free access
Research group Groupe Iselin Christophe (urologie) (106)
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WIRTH, Grégory Johann et al. Efavirenz-induced urolithiasis. In: Urological Research, 2006, vol. 34, n° 4, p. 288-9. doi: 10.1007/s00240-006-0052-6 https://archive-ouverte.unige.ch/unige:39034

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Deposited on : 2014-07-30

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