Rhabdomyolysis is a clinical syndrome characterized by necrosis of skeletal/striated muscle tissue and the release of intracellular elements into circulation, dominated by markedly elevated creatine kinase (CK) levels, myoglobinuria, and muscle weakness. Among the drugs that cause rhabdomyolysis, statins are most well-known, but many other drugs and their interactions can also trigger it. Polypharmacy nowadays represents a significant clinical challenge, especially in elderly patients and those with chronic illnesses. Combination of multiple drugs can lead to serious adverse effects. This paper presents a case in which the interaction between statins, ezetimibe, cyclosporine and clarithromycin led to the development of clinically significant rhabdomyolysis. Caution when prescribing medications, regular therapy reviews, and the use of available interaction-checking tools are key to preventing such adverse events.
Renal cell carcinoma (RCC) has a relatively high rate of metastasis which carries a grave prognosis, yet the location and presentation of metastatic disease can be quite unpredictable. We present a case of metastatic clear cell RCC presenting with nonspecific gastrointestinal symptoms before imaging revealed hepatoduodenal fistulization and multiple masses concerning for abscess vs metastases. Subsequent biopsy revealed an uncommon tumor marker profile. The ultimate diagnosis depended on piecing together the patient's clinical history, current presentation, and histopathological features.
Introduction: Chronic kidney disease (CKD) remains a major public health problem in sub-Saharan Africa, often underdiagnosed due to its silent progression. This study aims to estimate the prevalence of kidney disease markers and identify associated factors in the general adult population of Brazzaville. Methods: A cross-sectional survey was conducted in 2024 among 1629 adults aged ≥ 18 years. Data collected included sex, age, blood glucose, blood pressure, body mass index (BMI), serum creatinine, proteinuria (PU), and hematuria (HU). The presence of a renal marker was defined as serum creatinine ≥ 14 mg/L, proteinuria, and/or hematuria. Multivariate logistic regression was used to determine associated factors. Results: The overall prevalence of renal involvement was 25.3%. The most common abnormalities were proteinuria (31.9%) and elevated serum creatinine (17.5%). Significantly associated factors were male sex (OR = 1.68; 95% CI [1.38-2.05]), age > 65 years (OR = 1.71; 95% CI [1.16-2.53]), and overweight/obesity (OR = 1.37; 95% CI [1.10-1.71]). Conclusion : A quarter of the adult population of Brazzaville has at least one marker of kidney disease. These results, well above regional averages, highlight the urgent need to implement targeted screening and prevention strategies, particularly among older and overweight men.
