Acute reversible rhabdomyolysis during direct-acting antiviral hepatitis C virus treatment: a case report

Journal of Medical Case Reports

Hosam Alardati¹  Abdulrahman Qatomah²  Majidah Bukhari²  Mohammad Mawardi²  Edward Cupler³ 

[1] Department of Histopathology, King Faisal Specialist Hospital and Research Center, Prince Sultan Street, Ar Rawdah, 23433, Jeddah, Saudi Arabia;Department of Internal Medicine, Royal Victoria Hospital, McGill University, 1001 Decarie Blv, H4A 3J1, Montréal, Canada;Department of Neurology, King Faisal Specialist Hospital and Research Center, Prince Sultan Street, Ar Rawdah, 23433, Jeddah, Saudi Arabia;

关键词: Direct antiviral therapy;    Rhabdomyolysis;    Creatine kinase;    Sofosbuvir;    Case report;   

DOI  :  10.1186/s13256-021-03138-0

来源: Springer

【 摘 要 】

IntroductionTreatment of hepatitis C infection has evolved dramatically since 2011. Previous conventional therapy with interferon and ribavirin used to have a low sustained virological response rate of less than 40%. In the new direct-acting antiviral therapy era, a sustained virological response can be achieved in more than 90% of cases.Case presentationWe report a rare case of severe reversible acute rhabdomyolysis in a 31-year-old Saudi male patient with very long-chain acyl-coenzyme A dehydrogenase deficiency and chronic hepatitis C infection. The patient was clinically asymptomatic with no signs of decompensated liver disease.The patient received new direct-acting antiviral agents: sofosbuvir and daclatasvir. Fourteen days after initiation of direct-acting antiviral agents, the patient was found to have asymptomatic rhabdomyolysis. His creatine kinase peaked at 2572 IU/l, and he was treated conservatively; the direct-acting antiviral agents were discontinued and within 7 days, the patient’s creatine kinase levels normalized.ConclusionThis case highlights possible direct-acting antiviral agent-induced rhabdomyolysis in a patient with very-long-chain acyl-CoA dehydrogenase deficiency, presumably through alteration of mitochondrial membrane potential. Further studies are required to assess the possible impact and associations.

【 授权许可】

CC BY