Severe rhabdomyolysis during a hypersensitivity reaction to abacavir in a patient treated with ciprofibrate

Fontaine, C.; Guiard–Schmid, Jean–Baptiste; Slama, Laurence; Essid, Aben; Lukiana, Tuna; Rondeau, Eric B.; Pialoux, G.

doi:10.1097/01.aids.0000189861.44311.ed

Cited by 20 publications

(8 citation statements)

References 5 publications

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“…The mean peak CK reported for each of a variety of different causes and for patients with both single and multiple causes ranged from ∼10,000 to 25,000 in the largest series. [2,3]…”

Section: Discussionmentioning

confidence: 99%

“…Rhabdomyolysis is common in the HIV positive population, particularly in those with advanced disease. [3,5] Risk factors unique to this population includes HIV infection itself, opportunistic infections, co-infection with HCV, medication-related adverse effects (including pentamidine, trimethoprim-sulfamethoxazole, sulfadiazine, and antiretroviral agents, such as zidovudine, raltegravir and abacavir), drug–drug interactions, malignancy, alcohol and/or illicit drug abuse. [3,6,7] While infection is the most frequently encountered etiology of rhabdomyolysis among the HIV positive population, with sepsis being identified as major cause, Koubar et al demonstrated that 6% of cases of rhabdomyolysis in patients with HIV infection could be attributed to medications.…”

Section: Discussionmentioning

confidence: 99%

“…[1,2] Acute rhabdomyolysis has been described during primary HIV infection, and also as an adverse reaction to certain drugs, including antiretroviral therapy (ART). [3] At this time, we present an interesting case of rhabdomyolysis suspected to be associated with Triumeq , a side effect rarely described while receiving this ART combination.…”

Section: Introductionmentioning

confidence: 99%

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Case report of Triumeq (abacavir/dolutegravir/lamivudine) associated rhabdomyolysis in a human immunodeficiency virus (HIV) infected patient

Saad¹,

Casado-Castillo²,

Kelly³

2019

Medicine

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Rationale:With the existence of the human immunodeficiency virus (HIV) infection as a chronic disease, more often adverse effects of its treatment with the various antiretroviral therapies (ARTs) available have been recognized. Going further, Triumeq has been associated with a myriad of adverse effects, of which rhabdomyolysis is rarely reported in the literature.Patient concerns:The patient presented with muscle tenderness over the lower limbs and dark brown-to-red colored urine.Diagnosis:Given the presenting symptoms, as well as the laboratory testing, including elevated serum creatine kinase and liver enzymes, the diagnosis of rhabdomyolysis was made.Interventions:Improvement was achieved rapidly after starting intravenous fluid therapy and with discontinuation of Triumeq.OutcomesAfter discharge, repeated creatine kinase levels in the clinic have been normal and decision was made to initiate another ART and until now, no further episodes of rhabdomyolysis have developed. Regular outpatient follow-up has been ongoing for over 1 year and no complications have been identified.Lessons:This case aims to recognize rhabdomyolysis as a rare, but possible adverse effect associated with the use of Triumeq for HIV-infected patients and therefore clinicians prescribing this combination should be aware of this potential side effect and counsel their patients accordingly.

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“…The mean peak CK reported for each of a variety of different causes and for patients with both single and multiple causes ranged from ∼10,000 to 25,000 in the largest series. [2,3]…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Case report of Triumeq (abacavir/dolutegravir/lamivudine) associated rhabdomyolysis in a human immunodeficiency virus (HIV) infected patient

Saad¹,

Casado-Castillo²,

Kelly³

2019

Medicine

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“…HAART regimens can also interact through the cytochrome P450 system to increase the levels of other myotoxic medications including the commonly prescribed statins. There have been multiple reports of rhabdomyolysis in HIV-infected patients taking both HAART and statin therapy [68][69][70][71][72][73][74][75].…”

Section: Rhabdomyolysismentioning

confidence: 99%

Acute kidney injury in patients with human immunodeficiency virus infection

Cohen

Chawla

Kimmel

2008

Current Opinion in Critical Care

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“…[3] Recently, the ELISA titers of antibodies to BP180 NC16a were reported to fluctuate in parallel with the disease activity in HG patients. [5] The immunoblotting clearly showed positive reactivity at the 5 th , 12 th and 50 th day after delivery, which disappeared completely at the 120 th day after delivery. To further verify the ELISA results, we also performed immunoblotting of BP180 NC16a recombinant protein, which was a prototype method before the development of BP180 ELISA.…”

mentioning

confidence: 93%

A case of herpes gestationis: Follow-up study of autoantibodies using enzyme-linked immunosorbent assay and immunoblotting

Fukuda¹,

Ishii²,

Hamada³

et al. 2012

Indian J Dermatol Venereol Leprol

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1. Inui S, Nakao T, Itami S. Modulation of androgen receptor transcriptional activity by anti-acne reagents. J Dermatol Sci 2004;36:97-101. 2. Chew GY, Hawkins CA, Cherian M, Hurwitz M. Roxithromycin induced hypersensitivity pneumonitis. Pathology 2006;38:475-7. 3. Rahman Z, Weinberg J, Scheinfeld N. Minocycline hypersensitivity syndrome manifesting with rhabdomyolysis. Int J Dermatol 2002;41:530-1. 4. Compton MR, Crosby DL. Rhabdomyolysis associated with azathioprine hypersensitivity syndrome. Arch Dermatol 1996;132:1254-5. 5. Fontaine C, Guiard-Schmid JB, Slama L, Essid A, Lukiana T, Rondeau E, et al. Severe rhabdomyolysis during a hypersensitivity reaction to abacavir in a patient treated with ciprofibrate. AIDS 2005;19:1927-8.A case of herpes gestationis: Follow-up study of autoantibodies using enzyme-linked immunosorbent assay and immunoblotting Sir, Herpes gestationis (HG) is a rare autoimmune-mediated bullous disease that occurs during pregnancy and post partum, and may exacerbate after delivery. [1] IgG autoantibodies in HG bind to the 16 th noncollagenous domain (NC16a) of bullous pemphigoid antigen 180 (BP180), which is also recognized by bullous pemphigoid (BP). [2] We herein present a case of HG in which we examined the correlation among the results of enzymelinked immunosorbent assay (ELISA), immunoblotting and disease activity along the time course.A 27-year-old Japanese female in the 36 th week of her first pregnancy had a pruritic infiltrative erythema on the extremities. After delivery in the 38 th week of her pregnancy, she developed widespread infiltrative erythema with small tense vesicles on the extremities and back [ Figure 1a]. The patient also showed pruritic vesicles on the palms and soles, resembling dyshidrosis. The skin of her newborn baby was normal. A skin biopsy specimen taken from a lesion on the thigh revealed subepidermal blisters with perivascular eosinophilic and lymphocytic inflammatory infiltrate [ Figure 1b]. Direct immunofluorescence of the perilesional skin showed linear IgG and C3 deposits along the basement membrane zone (BMZ) [ Figure 1c]. Indirect and complement immunofluorescence using normal human skin as a substrate revealed circulating IgG anti-BMZ autoantibodies at a titer of 1:10. Indirect and complement immunofluorescence of the normal human skin split by 1 mol/L NaCl showed positive reaction (1:10) on the epidermal side of the split for IgG antibodies and C3 [ Figure 1d]. Immunoblotting using normal human epidermal extract revealed IgG antibodies to BP180 (data not shown). Immunoblotting using the recombinant protein of BP180 NC16a demonstrated that circulating IgG antibodies reacted with this protein. The BP180 ELISA index was positive (index: 79.42). These clinical and immunologic features lead us to the diagnosis of HG.Initial treatment with topical steroid for a week was not effective. At that time, antihistamine was not added because the patient refused to take it. Subsequently, a combination therapy with topical steroid and oral antihistamine (the patien...

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Severe rhabdomyolysis during a hypersensitivity reaction to abacavir in a patient treated with ciprofibrate

Cited by 20 publications

References 5 publications

Case report of Triumeq (abacavir/dolutegravir/lamivudine) associated rhabdomyolysis in a human immunodeficiency virus (HIV) infected patient

Case report of Triumeq (abacavir/dolutegravir/lamivudine) associated rhabdomyolysis in a human immunodeficiency virus (HIV) infected patient

Acute kidney injury in patients with human immunodeficiency virus infection

A case of herpes gestationis: Follow-up study of autoantibodies using enzyme-linked immunosorbent assay and immunoblotting

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