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Fluoroquinolone-induced serious, persistent, multisymptom adverse effects

Beatrice Alexandra Golomb1, Hayley Jean Koslik1, Alan J Redd2

  • 1Department of Medicine, University of California, San Diego, La Jolla, California, USA.

BMJ Case Reports
|October 7, 2015
PubMed

Insights

Fluoroquinolones (FQs) can cause severe, disabling symptoms like tendinopathy and neuropathy that persist after use. This mitochondrial toxicity may lead to a severe multisymptom condition.

Area of Science:

  • Pharmacology
  • Neurology
  • Toxicology

Background:

  • Fluoroquinolones (FQs) are broad-spectrum antibiotics.
  • Potential adverse effects of FQs are increasingly recognized.

Observation:

  • Four previously healthy adults developed severe, multisystem symptoms during or after FQ use.
  • Symptoms included tendinopathy, muscle weakness, neuropathy, autonomic dysfunction, sleep and cognitive disturbances, and psychiatric issues.

Findings:

  • Symptoms persisted and progressed even after FQ discontinuation.
  • The observed pathology aligns with FQ-induced delayed mitochondrial toxicity.
  • This suggests a potential mechanism for fluoroquinolone-induced mitochondrial neurogastrointestinal encephalomyopathy.

Implications:

  • Physicians and patients should be aware of the risk of severe, persistent FQ toxicity.
  • Early recognition and discontinuation of FQs may be crucial.
  • Further research into FQ-induced mitochondrial dysfunction is warranted.

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