Fuah Kar Wah, Lim Christopher
Department of Medicine, Hospital Tengku Ampuan Afzan, Kuantan, Pahang, Malaysia.
Unit of Nephrology, Department of Medicine, Universiti Putra Malaysia, Malaysia.
Indian J Nephrol. 2021 Mar-Apr;31(2):173-175. doi: 10.4103/ijn.IJN_5_20. Epub 2020 Nov 7.
Rhabdomyolysis is a syndrome with a wide range of symptoms ranging from asymptomatic raised serum creatinine kinase to life-threatening metabolic disturbances and acute kidney injury. A careful history taking and high clinical suspicion on drug-drug interaction are crucial to identify the etiology of rhabdomyolysis. Here, we present a case of rhabdomyolysis due to a rare drug-to-drug interaction of simvastatin, diltiazem, and cyclosporin in a patient with IgA nephropathy. Early renal replacement therapy was initiated, and the insulting agents were withheld. Despite the metabolic disturbances were corrected, the patient succumbed to possible venous thromboembolism event during the prolonged hospital stay. Therefore, heightened awareness is required in dealing with patients with glomerulonephritis who are frequently prescribed on polypharmacy, in order to reduce unwarranted adverse events.
横纹肌溶解症是一种具有广泛症状的综合征，从无症状的血清肌酸激酶升高到危及生命的代谢紊乱和急性肾损伤。仔细询问病史并对药物相互作用保持高度临床怀疑对于确定横纹肌溶解症的病因至关重要。在此，我们报告一例IgA肾病患者因辛伐他汀、地尔硫卓和环孢素罕见的药物相互作用导致横纹肌溶解症的病例。早期开始肾脏替代治疗，并停用致病药物。尽管代谢紊乱得到纠正，但患者在延长的住院期间死于可能的静脉血栓栓塞事件。因此，在处理经常接受多种药物治疗的肾小球肾炎患者时需要提高认识，以减少不必要的不良事件。
