Rhabdomyolysis secondary to influenza A H1N1 vaccine resulting in acute kidney injury
Rhabdomyolysis secondary to influenza A H1N1 vaccine resulting in acute kidney injury
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DOI：
10.1016/j.tmaid.2012.11.004
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发表时间：
2013-03-01
影响因子：
12
通讯作者：
Daher, Elizabeth de Francesco
中科院分区：
文献类型：
--
作者：
Callado, Rodrigo Barbosa;Ponte Carneiro, Tassia Gabrielle;Daher, Elizabeth de Francesco
甲型流感感染被描述为感染引起的横纹肌溶解症的主要病毒原因，但迄今为止，只有一例报道的病例被描述为由流感疫苗引起。我们描述了一名男性的病例，他一直在使用他汀类药物，并在接种甲型 H1N1 流感疫苗后第二天出现横纹肌溶解症。一名 58 岁男子因步态受损被送往急诊室。患者自述在入院前 5 天接种了甲型 H1N1 流感疫苗，并在接种后第二天开始出现症状。他报告了上行无力，下背部、上肢和下肢剧烈肌痛。入院实验室检查显示血清肌酸磷酸激酶：7600 IU/L，肌酐：3.0 mg/dL，尿素：185 mg/dL，天冬氨酸转氨酶：592 IU/L，丙氨酸转氨酶：630 IU/L，钾：5.4 mEq/L，乳酸脱氢酶：2828 111/L。尽管进行静脉输液治疗，患者仍持续少尿，尿量为0.17ml/kg/h。开始血液透析，两周后观察肾功能恢复情况。患者出院时血流动力学稳定且无症状。这是甲型 H1N1 流感疫苗罕见的副作用。医生应建议患者在出现肌肉症状时就医，并考虑疫苗接种导致横纹肌溶解的可能性。需要进行试验来更好地确定这种重要副作用的发生率。 (C) 2012 Elsevier Ltd. 保留所有权利。
Influenza A infection has been described as a major viral cause of infection-induced rhabdomyolysis, but to date, only one reported case was described as having been induced by influenza vaccine. We describe a case of a man who had been using statins and developed rhabdomyolysis the day after influenza A H1N1 vaccination. A 58-year-old man was admitted at the emergency room complaining of impaired gait. The patient reported receiving influenza A H1N1 vaccine 5 days prior to the admission, with symptoms beginning the day after the inoculation. He reported ascending weakness, intense myalgia in the lower back, upper and lower limbs. The admission laboratory tests showed serum creatine phosphokinase: 7600 IU/L, creatinine: 3.0 mg/dL, urea: 185 mg/dL, aspartate aminotransferase: 592 IU/L, alanine aminotransferase: 630 IU/L, potassium: 5.4 mEq/L, Lactate dehydrogenase: 2828 111/L. Despite intravenous fluid therapy, the patient still persisted with oliguria and urinary output of 0.17 ml/kg/h. Hemodialysis was initiated and renal function recovery was observed after two weeks. The patient was hemodynamically stable and asymptomatic at hospital discharge. This is a rare side effect of influenza A H1N1 vaccine. Physicians should advise patients to seek medical care when muscle symptoms are present and consider the possibility of rhabdomyolysis due to vaccination. Trials are required to better define the incidence of this important side effect. (C) 2012 Elsevier Ltd. All rights reserved.