Conservative treatment of lamivudine-induced rhabdomyolysis in a patient with acute exacerbation of chronic hepatitis B

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  • Hayashi Hidemi
    Department of Gastroenterology, Asahikawa Red Cross Hospital
  • Sawada Koji
    Division of Gastroenterology and Hematology/Oncology, Department of Medicine, Asahiakwa Medical University
  • Hasebe Takumu
    Division of Gastroenterology and Hematology/Oncology, Department of Medicine, Asahiakwa Medical University
  • Nakajima Syunsuke
    Division of Gastroenterology and Hematology/Oncology, Department of Medicine, Asahiakwa Medical University
  • Abe Masami
    Department of Gastroenterology, Asahikawa Red Cross Hospital
  • Hosoki Yayoi
    Department of Gastroenterology, Asahikawa Red Cross Hospital
  • Ohtake Takaaki
    Division of Gastroenterology and Hematology/Oncology, Department of Medicine, Asahiakwa Medical University Department of Clinical Gastroenterology and Hepatology on Co-operative Network, Asahikawa Medical University
  • Fujii Tsuneshi
    Department of Gastroenterology, Asahikawa Red Cross Hospital
  • Fujiya Mikihiro
    Division of Gastroenterology and Hematology/Oncology, Department of Medicine, Asahiakwa Medical University
  • Kohgo Yutaka
    Division of Gastroenterology and Hematology/Oncology, Department of Medicine, Asahiakwa Medical University
  • Hasebe Chitomi
    Department of Gastroenterology, Asahikawa Red Cross Hospital

Bibliographic Information

Other Title
  • 保存的治療にて救命し得たラミブジン誘発横紋筋融解症合併B型慢性肝炎急性増悪の1例
  • 症例報告 保存的治療にて救命し得たラミブジン誘発横紋筋融解症合併B型慢性肝炎急性増悪の1例
  • ショウレイ ホウコク ホゾンテキ チリョウ ニテ キュウメイ シエタ ラミブジン ユウハツ オウモンキン ユウカイショウ ガッペイ Bガタ マンセイ カンエン キュウセイ ゾウアク ノ 1レイ

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Description

A 50-year old man with chronic hepatitis B (CHB), dyslipidemia, nephrosclerosis, hypertension, and gout was referred to our hospital with a complaint of general fatigue. He was diagnosed with an acute exacerbation of CHB (AE of CHB) and treated with entecavir (ETV); however, his creatinine level increased. As ETV induced renal dysfunction or HBV associated nephropathy were suspected, ETV was discontinued and lamivudine (LAM) was administrated. After LAM treatment, aspartate aminotransferase (AST), serum creatinine kinase, and myoglobin levels markedly increased, and he was diagnosed with LAM-associated rhabdomyolysis. Immediate discontinuation of LAM and intravenous fluid therapy completely improved rhabdomyolysis. Although LAM-induced rhabdomyolysis is rare, rhabdomyolysis is poor prognosis with AE of CHB. When AST level unexpectedly increases despite of LAM administration in patients with AE of CHB, rhabdomyolysis should be considered as a differential diagnosis.

Journal

  • Kanzo

    Kanzo 56 (7), 341-347, 2015

    The Japan Society of Hepatology

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