Rhabdomyolysis and acute kidney injury requiring dialysis after norfloxacin-rosuvastatin coadministration

Georgios Oikonomou, Gianna Karapati, Maria Dafni, Vasiliki Tzavara
1st Department of Internal Medicine, Korgialenio-Benakio Red Cross General Hospital, Athens, Greece.

Abstract

Aims: The increasing use of electronic gadgets from medical students raises awareness for related health disorders such as visual complaints. A 67-year-old male presented at the Emergency Department, because of severe, gradually deteriorating weakness and muscle pain for the past fifteen days. He had been on norfloxacin for the last three weeks due to a recently diagnosed acute prostatitis. He was also receiving rosuvastatin as chronic treatment for dyslipidemia. Extended proximal muscle wasting was the only pathological finding after a thorough clinical examination, while the lab tests confirmed excessive acute rhabdomyolysis with consequent acute kidney injury, requiring hemodialysis.


During hospitalization extensive work up was not able to establish any specific diagnosis for the underlying disease. The aforementioned incident was eventually attributed to the co-administration of norfloxacin and rosuvastatin. Discontinuation of both drugs resulted in gradual alleviation of the symptoms, supporting our clinical hypothesis. However, the patient underwent multiple hemodialysis sessions for three months, before finally restoring his previous kidney function.