An Unexpected Cause of Hepatotoxicity and Myopathy in A Patient with Coronary Artery Disease: It Is Not Statin

Yıl 2018, Cilt: 21 Sayı: 1, 77 - 78, 01.04.2018

Gamze Babür Güler , Ekrem Güler Gültekin Günhan Demir Hacı Murat Güneş Zeynep İşıl Uğurad Öykü Önal Musallar

Öz

Sertraline
is a selective serotonin reuptake inhibitor; it is safe and effective for
treating depression in patients with coronary artery disease. Although nausea,
diarrhea, and dyspepsia are common adverse effects, less frequent reactions
such as maculopathy, hepatotoxicity, and rhabdomyolysis have also been
reported. In patients receiving multiple drugs for co-morbid conditions (heart
failure, coronary artery disease, etc.), these side effects can be
underdiagnosed. Here, we present a patient with coronary artery disease and
elevated liver function tests and skeletal muscle enzymes who had multiple
admissions and prolonged follow-ups in the emergency room because of elevated
creatine kinase and creatine kinase-MB levels, which delayed his appropriate
management including discontinuation of sertraline instead of statin.

Anahtar Kelimeler

Coronary artery disease, hepatotoxicity, myopathy, sertraline

Koroner Arter Hastalığı Olan Bir Hastada Beklenmedik Bir Hepatotoksisite ve Miyopati Nedeni: Statin Değil

Öz

Sertralin
koroner arter hastalığına eşlik eden depresyon durumlarında etkinliğini ve
güvenirliliğini kanıtlamış bir selektif serotonin geri alım inhibitörüdür. Sık
görülen yan etkileri yanında (bulantı, ishal, dispepsi) daha nadir görülen
(makülopati, hepatotoksisite, rabdomiyoliz) gibi yan etkileri de
bildirilmiştir. Çoklu ilaç kullanımının sık olduğu hastalarda (kalp
yetersizliği, koroner arter hastalığı gibi) depresyon tedavisinde sertralin
kullanımına bağlı yan etkiler gözden kaçabilmektedir. Biz karaciğer fonksiyon
testleri ve kas enzimleri yükselmiş bir koroner arter hastasında sertralinin;
statinlerden sonra etyolojik ajan olarak değerlendirildiği ve bu sürede
kreatinin kinaz, kreatinin kinaz-MB yüksekliği nedeniyle uzamış acil servis
takipleri olan bir olguyu sunuyoruz.

Anahtar Kelimeler

Koroner arter hastalığı, hepatotoksisite, miyopati, sertralin

Kaynakça

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