[Rhabdomyolysis associated with atorvastatin combined with amiodarone and fluconazole]
C C Franz1, M Bruggisser, S Krähenbühl
1Abteilung für Klinische Pharmakologie und Toxikologie und Regionales Pharmakovigilance Zentrum Basel, Universitätsspital Basel. Franzc@uhbs.ch
Abstract:
A 67-year old man was hospitalized due to an aorto-coronary bypass and cecal perforation. After administration of atorvastatin, amiodarone, and fluconazole, rhabdomyolysis developed with electrolyte disturbances (hyperphosphatemia, hyopcalcemia) and a massive increase in creatine kinase and myoglobin. In the clinical course, other complications manifested such as acute renal failure, critical illness myopathy, acute gout on the knee, and sternal infection with coagulase-negative staphylococci. After stopping the assumed causal agents and treating the complications, the patient could be transferred for rehabilitation after a more than two months hospital stay. We discuss the causes and symptoms of muscle diseases as well as the epidemiology, mechanisms, treatment, and prevention of drug-induced myopathies with a focus on statins.
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