Zhou Jingjing, Li Dongfeng, Cheng Qiansong
Department of Endocrinology of Lu'an Second People's Hospital, The Affiliated Hospital of West Anhui Health Vocational College.
Department of Hematology of Lu'an People's Hospital, The Lu'an Affiliated Hospital of Anhui Medical University, Lu'an, Anhui, China.
Medicine (Baltimore). 2020 May 22;99(21):e20390. doi: 10.1097/MD.0000000000020390.
Fibrates are widely used to control hypertriglyceridemia and mixed dyslipidemia alone or in combination with statins. These drugs have rare, but severe and potentially vital adverse reactions of rhabdomyolysis and secondary acute renal failure (ARF). The objective of this article is to analyze this adverse effect of fibrates and ensure the safety of drug use.
We report a case of rhabdomyolysis and ARF due to fenofibrate monotherapy in a 68-year-old female with post-pancreatitis diabetes mellitus and review reported cases of rhabdomyolysis correlated with fibrates monotherapy.
The patient was diagnosed with rhabdomyolysis associated with fenofibrate monotherapy as confirmed by symptoms of fatigue and muscle pain, and elevated levels of myoglobin and creatine kinase.
Fenofibrate therapy was discontinued. Moreover, intravenous fluids, urinary alkalization, and diuretic were performed.
The symptoms were completely relieved, and relevant laboratory indexes returned to normal range during follow-up.
Physicians should be aware of the side effect of rhabdomyolysis of fibrates, and patients should also be informed about this potential side effect, especially for patients with high-risk factors. A favorable outcome can be achieved by timely diagnosis and prompt treatment.
贝特类药物被广泛用于单独或与他汀类药物联合控制高甘油三酯血症和混合性血脂异常。这些药物有罕见但严重且可能危及生命的横纹肌溶解和继发性急性肾衰竭（ARF）不良反应。本文的目的是分析贝特类药物的这种不良反应并确保用药安全。
我们报告一例68岁患有胰腺炎后糖尿病的女性因单用非诺贝特治疗出现横纹肌溶解和ARF的病例，并回顾已报道的与贝特类单药治疗相关的横纹肌溶解病例。
通过疲劳和肌肉疼痛症状以及肌红蛋白和肌酸激酶水平升高确诊该患者患有与非诺贝特单药治疗相关的横纹肌溶解。
停用非诺贝特治疗。此外，进行了静脉补液、尿液碱化和利尿治疗。
随访期间症状完全缓解，相关实验室指标恢复正常范围。
医生应意识到贝特类药物横纹肌溶解的副作用，也应告知患者这种潜在副作用，尤其是对于有高危因素的患者。及时诊断和迅速治疗可取得良好结果。
