Nandy Anirban, Gaïni Shahin
Medical Department, Infectious Diseases Division, National Hospital Faroe Islands, Tórshavn, Faroe Islands.
Medical Department, Infectious Diseases Division, National Hospital Faroe Islands, Tórshavn, Faroe Islands; Infectious Diseases Research Unit, Odense University Hospital and University of Southern Denmark, Odense, Denmark; Faculty of Science and Technology, University of the Faroe Islands, Tórshavn, Faroe Islands.
Case Rep Med. 2016;2016:4705492. doi: 10.1155/2016/4705492. Epub 2016 Dec 27.
Atorvastatin and HMG-CoA reductase inhibitors are the most frequently used medication in the world due to very few adverse toxic side effects. One potentially life threatening adverse effect is caused by clinically significant statin induced rhabdomyolysis, either independently or in combination with fusidic acid. The patient in our case who previously had cardiac insufficiency, atrial fibrillation, and thoracic aorta aneurysm and was treated with insertion of an endovascular metallic stent in the aorta is presented in the report. He had an inoperable aortitis with an infected stent and para-aortic abscesses with no identified microorganism. The patient responded well to empirical antibiotic treatment with combination therapy of fusidic acid and moxifloxacin. This treatment was planned as a lifelong prophylactic treatment. The patient had been treated with atorvastatin for several years. He developed severe rhabdomyolysis when he was started on fusidic acid and moxifloxacin. The patient made a fast recovery after termination of treatment with atorvastatin and fusidic acid. We here report a life threatening complication of rhabdomyolysis that physicians must be aware of. This can happen either in atorvastatin monotherapy or as a complication of pharmacokinetic interaction between atorvastatin and fusidic acid.
阿托伐他汀和HMG-CoA还原酶抑制剂是世界上使用最频繁的药物，因为其不良毒副作用极少。一种潜在的危及生命的不良反应是由临床上显著的他汀类药物诱导的横纹肌溶解引起的，该反应可单独发生，也可与夫西地酸联合发生。本报告介绍了我们的一位患者，他既往有心脏功能不全、心房颤动和胸主动脉瘤，并接受了主动脉内血管金属支架植入治疗。他患有无法手术的主动脉炎，伴有感染的支架和主动脉旁脓肿，未发现微生物。该患者对夫西地酸和莫西沙星联合经验性抗生素治疗反应良好。该治疗计划作为终身预防性治疗。该患者已服用阿托伐他汀数年。当他开始使用夫西地酸和莫西沙星时，发生了严重的横纹肌溶解。在停用阿托伐他汀和夫西地酸治疗后，患者迅速康复。我们在此报告一种危及生命的横纹肌溶解并发症，医生必须对此有所警惕。这可能发生在阿托伐他汀单药治疗中，也可能是阿托伐他汀与夫西地酸之间药代动力学相互作用的并发症。
