To the Editor,
We have a case experienced vaccine-induced rhabdomyolysis during fibrate therapy.
A 65 years old male patient admitted to the hospital with weakness and pain of the extremity muscles. He had tenderness widespread of the body and feel difficulty to move. He had coronary heart disease and hyperlipidemia. He was taking 267 mg of fenofibrate daily for 5 months and had influenza vaccine (Vaxigrip, Sanofi, Lyon, France) administration a week before admission to the hospital. Laboratory examination showed markedly elevated serum creatine kinase levels (27,730 U/L) and creatinin was 2.16 mg/dL. The creatinin level was in normal range before the vaccine. After discontinuing the fibrate therapy and adequate fluid resuscitation renal function recovered and the symptoms of myopathy resolved and also creatine kinase levels turned to normal range.
Rhabdomyolysis is a skeletal muscle cell damage associated with the release of toxic components of the cells (1). The causes of this situation vary widely as crush injury, muscular activity, drugs, infectious diseases, rheumatologic and endocrinologic disorders (2). The clinicians face a challenge when they recognise the rhabdomyolysis. Fibrate therapy and influenza vaccine both were reported as a possible cause of rhabdomyloysis previously (3–5). But it’s obvious that a few reports have been done. In conclusion, the influenza vaccine has to be kept in mind as a myotoxic reason especially if it is administered during the other myotoxic treatment.
Footnotes
Ethics Committee Approval: N/A.
Informed Consent: Written informed consent was obtained from the patient.
Peer-review: Externally peer-reviewed.
Author Contributions: All authors contributed equally during the preparation of this manuscript.
Conflict of Interest: No conflict of interest was declared by the authors.
Financial Disclosure: The author declared that this study has received no financial support.
References
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