Rhabdomyolysis probably induced by influenza vaccine and fibrate therapy.

A 65 years old male patient admitted to the hospital with weakness and pain of the extremity muscles. He had tenderness widespread of the body and feel difficulty to move. He had coronary heart disease and hyperlipidemia. He was taking 267 mg of fenofibrate daily for 5 months and had influenza vaccine (Vaxigrip, Sanofi, Lyon, France) administration a week before admission to the hospital. Laboratory examination showed markedly elevated serum creatine kinase levels (27,730 U/L) and creatinin was 2.16 mg/dL. The creatinin level was in normal range before the vaccine. After discontinuing the fibrate therapy and adequate fluid resuscitation renal function recovered and the symptoms of myopathy resolved and also creatine kinase levels turned to normal range.