Fluoroquinolone-induced Achilles tendinitis

Tam, Pui Kit; Ho, Carmen Tze Kwan

doi:10.12809/hkmj134105

Cited by 12 publications

(33 citation statements)

References 11 publications

(15 reference statements)

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“…FQs can also cause renal dysfunction or failure,80–89 which could possibly magnify the risk of other FQ AEs. Beyond renal dysfunction90 91 and older age,90 91 FQ AEs are reported to be increased with use of steroids,44 90 91 with strenuous physical activity (where increased energy demand magnifies any damage associated with mitochondrial dysfunction and impaired energy supply),91 92 use of renin-angiotensin blockers,93 and settings of concurrent mitochondrially toxic agents—such as chemotherapy,88 HIV protease inhibitors,87 94 95 statins92 and amiodarone45 90 96–98 (or class III antiarrhythmics, more generally). Impaired mitochondrial function more commonly might amplify risk, but routine assessments are not available.…”

Section: Discussionmentioning

confidence: 99%

Fluoroquinolone-induced serious, persistent, multisymptom adverse effects

Golomb¹,

Koslik

Redd

2015

BMJ Case Reports

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SUMMARYWe present a case series of four previously healthy, employed adults without significant prior medical history in each of whom symptoms developed while on fluoroquinolones (FQs), with progression that continued following discontinuation evolving to a severe, disabling multisymptom profile variably involving tendinopathy, muscle weakness, peripheral neuropathy, autonomic dysfunction, sleep disorder, cognitive dysfunction and psychiatric disturbance. Physicians and patients should be alert to the potential for FQ-induced severe disabling multisymptom pathology that may persist and progress following FQ use. Known induction by FQs of delayed mitochondrial toxicity provides a compatible mechanism, with symptom profiles (and documented mechanisms of FQ toxicity) compatible with the hypothesis of an exposure-induced mitochondrial neurogastrointestinal encephalomyopathy. BACKGROUND

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Section: Discussionmentioning

confidence: 99%

Fluoroquinolone-induced serious, persistent, multisymptom adverse effects

Golomb¹,

Koslik

Redd

2015

BMJ Case Reports

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“…This pain is usually of a sudden onset, and may be accompanied by acute signs of inflammation and swelling, which was presented as well. The diagnosis is made by acute/sub-acute onset of pain and swelling over the tendon, together with a history of recent use of FQ and the absence of other obvious causes of tendinopathy [3].…”

Section: Discussionmentioning

confidence: 99%

“…According to Corrao et al [16], patients over 60 years of age treated with FQ from 1 to 30 days have a 1.5-2.7 times higher risk of tendon injury including rupture compared to younger patients (under 60 years of age). Some reviews indicate that men are more likely to develop rupture [3,12].…”

Section: Discussionmentioning

confidence: 99%

“…The diagnosis is usually clinical, although the use of imaging methods such as ultrasound or magnetic resonance imaging can be helpful. Typical US findings of tendinopathy are thickened tendon with increased blood flow seen in color Doppler examination [3]. Magnetic resonance imaging can be clinically helpful especially in the presence of questionable diagnosis or for tear localization during presurgical planning [20].…”

Section: Discussionmentioning

confidence: 99%

“…Therefore we wish to recall adverse events in the musculoskeletal system and to indicate patients at higher risk. Most of the cases of rupture are associated with other risk factors such as older age, glucocorticoid use and rheumatic, vascular or renal diseases [2][3][4].…”

Section: Introductionmentioning

confidence: 99%

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Acute Achilles tendon rupture after levofloxacin in a patient with giant cell arteritis

Stasiek¹,

Głuszko²

2019

Reumatologia

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The authors report a case of a 67-year-old woman with giant cell arteritis with acute Achilles tendon rupture, which occurred after 3 days of levofloxacin therapy introduced because of newly diagnosed erosive gastritis associated with Helicobacter pylori infection. The Achilles tendon rupture was surgically treated and the patient made a complete recovery. In view of the widespread use of levofloxacin in practice, this case report raises important clinical implications. Tendinopathies are a known complication, quite rare in the healthy population, but the risk of rupture significantly increases in the population of patients over 60 years of age, with chronic usage of glucocorticosteroids, impaired renal function and recipients of organ transplants. What needs underlining, there are also described differences between individual fluoroquinolones as a cause of tendon damage in this group. Considering the widespread use of this group of drugs in patients, knowledge about the risk of adverse events including tendinopathy promotes safe use of fluoroquinolones.

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Ciprofloxacin

2015

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Fluoroquinolone-induced Achilles tendinitis

Cited by 12 publications

References 11 publications

Fluoroquinolone-induced serious, persistent, multisymptom adverse effects

Fluoroquinolone-induced serious, persistent, multisymptom adverse effects

Acute Achilles tendon rupture after levofloxacin in a patient with giant cell arteritis

Ciprofloxacin

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