Fluoroquinolone-Associated Tendinopathy: An Important Complication of Cyst Infection Management in Polycystic Kidney Disease

Miwa Kaneko, Tetsu Akimoto, Daisuke Nagata Division of Nephrology, Department of Internal Medicine, Jichi Medical University, Tochigi, JapanCorrespondence: Tetsu Akimoto, Division of Nephrology, Department of Internal Medicine, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke-Shi, Tochigi, 329-0498, Japan, Tel +81-285-58-7346, Fax +81-285-44-4869, Email tetsu-a@jichi.ac.jpAbstract: A 68-year-old man on hemodialysis treatment for end-stage kidney disease secondary to autosomal dominant polycystic kidney disease (ADPKD) complained of right ankle pain that impaired walking ability two weeks after the initiation of intravenous levofloxacin as a treatment for concomitant liver cyst infection. A systemic workup led us to conclude that our patient had a fluoroquinolone-associated tendon injury. Such a disease condition has been recognized as a serious adverse event resulting from the receipt of fluoroquinolones in various clinical settings. Fluoroquinolones have received focus as standard therapeutic agents for liver and/or renal cyst infection because of their lipophilic properties that lead to good penetration into infected cysts. However, reports on fluoroquinolone-associated tendinopathy in patients with ADPKD associated with cyst infection are sparse. We believe the current report illustrates the pitfalls associated with managing patients with ADPKD who are subjected to the administration of fluoroquinolones due to infectious complications.Keywords: ADPKD, renal failure, cyst, infection, fluoroquinolone-associated tendon injuries