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Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Myotoxicity of telbivudine in pre-existing muscle damage | Finsterer and Ay Virology Journal 2010 7 323 http www.virologyj.eom content 7 1 323 VIROLOGY JOURNAL CASE REPORT Open Access Myotoxicity of telbivudine in pre-existing muscle damage Josef Finsterer1 Leyla Ay2 Abstract Objectives It is unknown if telbivudine causes muscle damage only in patients with pre-existing muscle pathology. Case report A 27 yo male of African origin received telbivudine for hepatitis B during 3 months. Three weeks after initiation of the drug he developed myalgia and tiredness. Creatine-kinase increased from 278 U l n 170 U l at baseline to 3243 U l. Shortly after discontinuation of telbivudine muscle symptoms and hyper-CK-emia disappeared. The findings suggest that pre-existing muscle damage favored the myotoxic effect of telbivudine. Conclusions Telbivudine appears to cause accelerated muscle toxicity if given to patients who already have muscle damage. Patients under telbivudine should be closely monitored for muscular side effects and those with pre-existing muscle damage should not receive the drug. Introduction Telbivudine has been reported to cause moderate hyper-CK-emia in 9-12 of the treated patients 1 2 . The following case is important because it indicates that hyper-CK-emia from telbivudine occurs predominantly in patients with pre-existing subclinical muscle damage. Case report The patient is a 27 yo HIV-negative male of African origin with a language barrier and a history of inactive hepatitis C right-sided omalgia a single episode of a polymorphic psychosis at age 26 y mild chronic renal insufficiency creatinine 1.2 mg dl n 1.1.mg dl at least since age 25 y mild recurrent hyper-CK-emia leucopenia and thrombopenia recurrent abdominal pain presumably from chronic pancreatitis and hyper-gam-maglobulinemia table 1 . His family history was negative for neuromuscular disorder. At age 24 y hepatitis B was diagnosed. The patient received various antiviral therapies such as lamivudine adefovir dipivoxil and fenofovir always for a short
