Simvastatin Induced Acute Rhabdomyolysis in a Renal Transplant Patient
Journal Name:
- Türk Nefroloji, Diyaliz ve Transplantasyon Dergisi
Key Words:
Keywords (Original Language):
| Author Name | University of Author | Faculty of Author |
|---|---|---|
Abstract (2. Language):
The risk of development of rhabdomyolysis and myoglobinuric
acute graft failure is higher than the general population in renal
transplant recipients with concomitant use of cyclosporine
A and statin. A 64-year-old female patient, who underwent
renal transplantation from a living donor in Germany 14 years
ago, had diabetes mellitus, hyperlipidemia and hypertension
in her past medical history. During her follow up in this
country, simvastatin 80 mg/day was added to her therapy due
to hyperlipidemia. Her biochemical analysis revealed serum
creatine phosphokinase (CPK) of 27336 u/L, cretine kinase
–MB (CK-MB): >300 ng/mL, myoglobin >4000 ng/mL, urea:
284 mg/dL, creatinine: 5.1 mg/dL and cyclosporine level:
145.6. Although her serum CPK, CK-MB, myoglobin levels
returned to normal levels during her 25-day follow-up, her
renal function test levels did not improve and she was accepted
to have chronic renal failure. An AV fistula was opened and
she was entered into a routine hemodialysis program. In
conclusion, simvastatin may cause serious adverse effects in
renal transplant patients. One should be very careful and the
patient should be followed very closely when it is used.
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Abstract (Original Language):
Uzun dönemde renal transplant alıcılarında mortalite
ve morbiditeyi etkileyen en sık sebep kardiyovasküler
hastalıklardır. Canlı donörden Almanya’da 14 yıl önce
böbrek nakli yapılan 63 yaşındaki kadın hastanın diabetes
mellitus, hiperlipidemi ve hipertansiyon tanıları vardı.
Hastaya bu ülkedeki takiplerinde hiperlipidemisi nedeniyle
de simvastatin 80 mg eklenmişti. Hastanın biyokimyasal
parametrelerinde serum CPK: 27336 u/L, CK-MB: >300 ng/
mL, myoglobin >4000 ng/mL, üre: 284 mg/dL, kreatinin: 5,1
mg/dL, siklosporin düzeyi:145,6 saptandı. Yaklaşık 25 günlük
takibinde serum CPK, CK-MB, myoglobin değerleri normal
seviyelere gelmesine rağmen böbrek fonksiyon testleri yüksek
seyretmesi üzerine kronik rejeksiyon kabul edildi. AV fistül
açılarak kronik hemodiyaliz programına alındı. Sonuç olarak;
böbrek nakilli hastalarda simvastatin ciddi yan etkilere neden
olabilir; kullanılacağı zaman doz ayarlamasında çok dikkatli
olunmalı ve rabdomyoliz açısından yakından izlenmelidir.
FULL TEXT (PDF):
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