Kaneko Miwa, Akimoto Tetsu, Nagata Daisuke
Division of Nephrology, Department of Internal Medicine, Jichi Medical University, Tochigi, Japan.
Int Med Case Rep J. 2024 Sep 6;17:777-781. doi: 10.2147/IMCRJ.S471718. eCollection 2024.
A 68-year-old man on hemodialysis treatment for end-stage kidney disease secondary to autosomal dominant polycystic kidney disease (ADPKD) complained of right ankle pain that impaired walking ability two weeks after the initiation of intravenous levofloxacin as a treatment for concomitant liver cyst infection. A systemic workup led us to conclude that our patient had a fluoroquinolone-associated tendon injury. Such a disease condition has been recognized as a serious adverse event resulting from the receipt of fluoroquinolones in various clinical settings. Fluoroquinolones have received focus as standard therapeutic agents for liver and/or renal cyst infection because of their lipophilic properties that lead to good penetration into infected cysts. However, reports on fluoroquinolone-associated tendinopathy in patients with ADPKD associated with cyst infection are sparse. We believe the current report illustrates the pitfalls associated with managing patients with ADPKD who are subjected to the administration of fluoroquinolones due to infectious complications.
一名68岁男性因常染色体显性多囊肾病(ADPKD)继发终末期肾病接受血液透析治疗,在静脉注射左氧氟沙星治疗伴发的肝囊肿感染两周后,出现右踝疼痛,行走能力受损。全面的系统检查使我们得出结论,该患者患有氟喹诺酮类药物相关的肌腱损伤。这种病症已被公认为在各种临床环境中使用氟喹诺酮类药物导致的严重不良事件。由于氟喹诺酮类药物具有亲脂性,能很好地渗透到受感染的囊肿中,因此一直是治疗肝和/或肾囊肿感染的标准治疗药物。然而,关于ADPKD伴囊肿感染患者发生氟喹诺酮类药物相关肌腱病的报道很少。我们认为本报告说明了在管理因感染性并发症而接受氟喹诺酮类药物治疗的ADPKD患者时所面临的陷阱。