Franz C C, Bruggisser M, Krähenbühl S, Rätz Bravo A E
Abteilung für Klinische Pharmakologie und Toxikologie und Regionales Pharmakovigilance Zentrum Basel, Universitätsspital Basel.
Praxis (Bern 1994). 2011 Mar 2;100(5):273-84. doi: 10.1024/1661-8157/a000491.
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.
一名67岁男性因主动脉冠状动脉搭桥术和盲肠穿孔入院。在使用阿托伐他汀、胺碘酮和氟康唑后，出现横纹肌溶解，并伴有电解质紊乱（高磷血症、低钙血症）以及肌酸激酶和肌红蛋白大量增加。在临床过程中，还出现了其他并发症，如急性肾衰竭、危重病性肌病、膝关节急性痛风以及凝固酶阴性葡萄球菌引起的胸骨感染。在停用可能的致病药物并治疗并发症后，患者在住院两个多月后得以转至康复机构。我们讨论了肌肉疾病的病因和症状，以及药物性肌病的流行病学、机制、治疗和预防，重点是他汀类药物。
