Rhabdomyolysis after midazolam administration in a cirrhotic patient treated with atorvastatin

作     者：Antonietta Gigante Gianluca Di Lazzaro Giraldi Maria Ludovica Gasperini Biagio Barbano Marta Liberatori Liborio Sardo Francesca Di Mario Antonella Giorgi Filippo Rossi-Fanelli Antonio Amoroso 

作者机构：Department of Clinical Medicine"Sapienza" University of Rome00185 RomeItaly 

出 版 物：《World Journal of Gastrointestinal Pharmacology and Therapeutics》 (世界胃肠药理与治疗学杂志（英文版）（电子版）)

年 卷 期：2014年第5卷第3期

页      面：196-199页

学科分类：1002[医学-临床医学] 100210[医学-外科学(含：普外、骨外、泌尿外、胸心外、神外、整形、烧伤、野战外)] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

主　　题：Rhabdomyolysis Chronic liver disease Statins Midazolam Alcoholic liver cirrhosis 

摘      要：The administration of statins in patients with liver disease is not an absolute contraindication. Hepatotoxicity is a rare and often dose-related event and in the literature there are only a few described cases of fatal rhab-domyolysis in patients with chronic liver disease after statin administration. During treatment with 3-hydroxy-3-methylglutaryl-coenzyme A reductase inhibitors,the factors responsible for myopathy may either be related to the patient,or due to interactions with other medications that are metabolic substrates of the same isozymes and therefore able to increase blood statin concentration. The most important side effects consist of increased transaminase levels,abdominal pain or muscle weakness,increased serum levels of creatine kinase and rhabdomyolysis. In this article we report a case of fatal rhabdomyolysis with acute renal failure after gastric endoscopy,where midazolam was used as a sedation agent in a patient with chronic liver disease treated with a high dose of atorvastatin. Therefore,we suggest paying particular attention to the potential risks of associating atorvastatin and midazolam in patients with chronic liver disease who need to undergo gastric endoscopy.