Abstract
A 83-year-old female patient suffered from acute kidney injury a month after percutaneous coronary intervention. Two weeks before hospitalization, she experienced nausea and intermittent watery diarrhea. Laboratory test showed high levels of serum creatine kinase and lactate dehydrogenase, which were remarkably decreased after ceasing rosuvastatin and valsartan treatment. Despite the recovery of renal function, unfortunately one week later, she was diagnosed with agranulocytosis because of antibiotic therapy. When we stopped meropenem and switched to granulocyto-colony stimulating factor treatment, her white blood cell count returned to a normal range. In our case, both rhabdomyolysis and agranulocytosis were induced by drugs. We provided a literature review of the causes of acute kidney injury and the pathogenesis of rhabdomyolysis and agranulocytosis. We discussed how drugs might lead to these complications. This case highlights the need to be aware of the potential side effects of drugs, especially those given to elderly patients who are likely to be receiving several medications concurrently for managing chronic diseases.
Highlights
Due to the increase in life expectancy, more geriatric patients are present in the hospital
According to the Acute Kidney Injury Network (AKIN) [3] and Risk, Injury, Failure, Loss, and End-stage (RIFLE) kidney disease criteria [4], this patient can be diagnosed as stage 3 acute kidney injuries (AKI)
The potential causes of such acute exacerbation include (1) contrast-induced nephropathy (CIN) after the percutaneous coronary intervention (PCI), (2) application of RAS inhibitors, (3) hypovolemia and prerenal renal failure caused by acute gastrointestinal infections and diarrhea, and (4) rhabdomyolysis caused by statins
Summary
Due to the increase in life expectancy, more geriatric patients are present in the hospital. We report a case of acute kidney injury induced by rhabdomyolysis in an elderly patient who recently underwent a percutaneous coronary intervention She suffered from agranulocytosis induced by antibiotic drugs. A 83-year-old female patient was admitted due to a continuous increase in serum creatinine (sCr) level peaked at 715 μmol/L She has a past medical history of coronary heart disease and atrial fibrillation for over 10 years, taking amiodarone and betaloc to control ventricular rate. This patient had undergone a coronary angiography and percutaneous coronary intervention (PCI) after presenting with chest tightness and chest pain She routinely took clopidogrel 75 mg/d and aspirin 100 mg/d for preventing platelet aggregation and rosuvastatin 10 mg/d for plaque stabilization after PCI.
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