Case report: severe myoclonus associated with oral midodrine treatment for hypotension.
Medicine (Baltimore)
; 99(40): e21533, 2020 Oct 02.
Article
em En
| MEDLINE
| ID: mdl-33019383
ABSTRACT
RATIONALE Midodrine is widely used in the treatment of hypotensive states, there have been no reports of myoclonus associated with midodrine use in hypotension with chronic kidney disease. PATIENT CONCERNS We report a 58-year-old female patient with chronic kidney disease (CKD) presenting with involuntary tremor 2âh after taking midodrine, which became more frequent after 6âh. Brain CT and neurological examination did not yield findings of note. Blood chemistry showed serum albumin of 3.1âg/L, ALT of 19âU/L, AST of 22âU/L, SCr of 273.9âµmol/L, K of 2.94âmmol/L, Ca of 1.63âmmol/L, and Mg of 0.46âmmol/L. Her BP was maintained at 83-110/56-75âmmHg. Her urine volume was 600-1000âmL/d, and her heart rate was within a range of 90-100âbeats/min. DIAGNOSIS Chronic kidney disease (CKD), hypotension, metabolic acidosis, hypocalcemia, hypokalemia, and hypomagnesemia. INTERVENTIONS:
Midodrine treatment was stopped and the patient was treated with intravascular rehydration and furosemide. Myoclonus ceased one day after midodrine withdrawal. LESSONS Oral midodrine is widely used in the treatment of orthostatic hypotension, recurrent reflex syncope and dialysis-associated hypotension and the adverse effects are mostly mild. However, clinicians should be alert for midodrine-induced myoclonus, especially in patients with CKD.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Agonistas de Receptores Adrenérgicos alfa 1
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Hipotensão
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Midodrina
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Mioclonia
Tipo de estudo:
Etiology_studies
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Risk_factors_studies
Limite:
Female
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Humans
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Middle aged
Idioma:
En
Ano de publicação:
2020
Tipo de documento:
Article