Influenza A‐induced rhabdomyolysis and acute kidney injury complicated by posterior reversible encephalopathy syndrome

Fearnley, R. A.; Lines, Simon W.; Lewington, Andrew; Bodenham, A.

doi:10.1111/j.1365-2044.2011.06752.x

Cited by 25 publications

(21 citation statements)

References 19 publications

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“…Accordingly to Naranjo's probability scale a probable relationship between levofloxacin and rhabdomyolysis (total score 5) was confirmed even if simvastatin was considered to be an alternative cause of the adverse event (Table 1). Furthermore, all other potential reasons of muscle damage, such as Influenza A and B virus [11], Parainfluenza type 1 and 2 virus [12], Coxsackie virus [13], HIV 1-2 virus [14], endocrinological abnormalities [15], and autoimmune myositis could be serologically excluded. Serum and urinary antigen and antibodies exams excluded Legionella pneumophila , Mycoplasma pneumoniae , Chlamydia pneumoniae , and Streptococcus pneumoniae as potential pathogens of the community acquired pneumonia.…”

Section: Discussionmentioning

confidence: 99%

Acute Rhabdomyolysis Associated with Coadministration of Levofloxacin and Simvastatin in a Patient with Normal Renal Function

Paparoupa

Pietrzak

Gillissen

2014

Case Reports in Medicine

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We report a rare case of severe acute rhabdomyolysis in association with coadministration of levofloxacin and simvastatin in a patient with normal renal function. A 70-year-old Caucasian male was treated due to community acquired pneumonia with levofloxacin in a dosage of 500 mg once and then twice a day. On the 8th day of hospitalization the patient presented with acute severe rhabdomyolysis requiring an intensive care support. After discontinuation of levofloxacin and concomitant medication with simvastatin 80 mg/day, clinical and laboratory effects were totally reversible. Up to now, levofloxacin has been reported to induce rhabdomyolysis mainly in patients with impaired renal function, as the medication has a predominant renal elimination. In our case renal function remained normal during the severe clinical course. According to a recent case report rhabdomyolysis was observed due to interaction of simvastatin and ciprofloxacin. To our best knowledge this is the first case of interaction between simvastatin and levofloxacin to be reported. This case emphasizes the need of close monitoring of creatine kinase in patients under more than one potentially myotoxic medication especially when patients develop muscle weakness.

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Section: Discussionmentioning

confidence: 99%

Acute Rhabdomyolysis Associated with Coadministration of Levofloxacin and Simvastatin in a Patient with Normal Renal Function

Paparoupa

Pietrzak

Gillissen

2014

Case Reports in Medicine

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“…Elevated creatine kinase (CK) has been implicated as a contributing factor for AKI in pH1N1 [14,17,22,28]. Pettila et al reported that 15.8% of AKI patients had CK levels exceeding 5000 IU/L and found a trend of increasing CK levels with worsening AKI [26].…”

Section: Discussionmentioning

confidence: 99%

“…Recently, reports have described the incidence and outcomes of AKI among critically ill adult and pediatric pH1N1 patients [13]–[28]. Many studies, however, were limited by design (case reports [14,17,20,22,24,28] or small case series [13,15,18,21,27]), small sample size [16,19,25], or single-center enrollment [13,15,16,18,21]. There have been few larger scale prospective multi-center cohorts [19,23,26], none of which described the Canadian pandemic.…”

Section: Introductionmentioning

confidence: 99%

Acute kidney injury among critically ill patients with pandemic H1N1 influenza A in Canada: cohort study

et al. 2013

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BackgroundCanada’s pandemic H1N1 influenza A (pH1N1) outbreak led to a high burden of critical illness. Our objective was to describe the incidence of AKI (acute kidney injury) in these patients and risk factors for AKI, renal replacement therapy (RRT), and mortality.MethodsFrom a prospective cohort of critically ill adults with confirmed or probable pH1N1 (16 April 2009–12 April 2010), we abstracted data on demographics, co-morbidities, acute physiology, AKI (defined by RIFLE criteria for Injury or Failure), treatments in the intensive care unit, and clinical outcomes. Univariable and multivariable logistic regression analyses were used to evaluate the associations between clinical characteristics and the outcomes of AKI, RRT, and hospital mortality.ResultsWe included 562 patients with pH1N1-related critical illness (479 [85.2%] confirmed, 83 [14.8%] probable]: mean age 48.0 years, 53.4% female, and 13.3% aboriginal. Common co-morbidities included obesity, diabetes, and chronic obstructive pulmonary disease. AKI occurred in 60.9%, with RIFLE categories of Injury (23.0%) and Failure (37.9%). Independent predictors of AKI included obesity (OR 2.94; 95%CI, 1.75-4.91), chronic kidney disease (OR 4.50; 95%CI, 1.46-13.82), APACHE II score (OR per 1-unit increase 1.06; 95%CI, 1.03-1.09), and PaO2/FiO2 ratio (OR per 10-unit increase 0.98; 95%CI, 0.95-1.00). Of patients with AKI, 24.9% (85/342) received RRT and 25.8% (85/329) died. Independent predictors of RRT were obesity (OR 2.25; 95% CI, 1.14-4.44), day 1 mechanical ventilation (OR 4.09; 95% CI, 1.21-13.84), APACHE II score (OR per 1-unit increase 1.07; 95% CI, 1.03-1.12), and day 1 creatinine (OR per 10 μmol/L increase, 1.06; 95%CI, 1.03-1.10). Development of AKI was not independently associated with hospital mortality.ConclusionThe incidence of AKI and RRT utilization were high among Canadian patients with critical illness due to pH1N1.

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“…Congenital disorders of metabolism of organic and fatty acids may be rapidly exacerbated by influenza, mimicking acute encephalopathy . There also are case reports of acute encephalitis with refractory, repetitive partial seizures (AERRPS), and posterior reversible encephalopathy syndrome (PRES) …”

Section: Major Syndromes Of Influenza Encephalopathymentioning

confidence: 99%

Influenza encephalopathy and related neuropsychiatric syndromes

Mizuguchi

2013

Influenza Resp Viruses

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Influenza is occasionally complicated by CNS disorders, in particular impairment of consciousness. Severe disorders encompass multiple, distinct syndromes manifesting acute encephalopathy, whereas mild disorders represent multiple, ill‐defined neuropsychiatric syndromes. Acute encephalopathy is manifested with seizures and coma, with or without multi‐organ involvement. The outcome varies from death or neurologic sequelae to recovery and differs among syndromes. Transient neuropsychiatric disorders are manifested with delirium and/or abnormal behavior. There also are multiple syndromes. The outcome is usually favorable, although occasional fatal accidents warrant caution.

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Influenza A‐induced rhabdomyolysis and acute kidney injury complicated by posterior reversible encephalopathy syndrome

Cited by 25 publications

References 19 publications

Acute Rhabdomyolysis Associated with Coadministration of Levofloxacin and Simvastatin in a Patient with Normal Renal Function

Acute Rhabdomyolysis Associated with Coadministration of Levofloxacin and Simvastatin in a Patient with Normal Renal Function

Acute kidney injury among critically ill patients with pandemic H1N1 influenza A in Canada: cohort study

Influenza encephalopathy and related neuropsychiatric syndromes

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