Rhabdomyolysis after Transplantation: Case Report after Allogeneic Hematopoietic Transplantation and Review of Literature

We describe a case of flaccid paraparesis, intervening during treatment with simvastatin cyclosporine and low dose posaconazole, in a patient previously having undergone allogeneic hematopoietic transplantation. Final diagnosis was rhabdomyolysis related to statin. This is the first case reporting posaconazole as an agent favoring rhabdomyolysis when administered together with simvastatin and cyclosporine. In this patient, a low Vitamin D level may also have contributed to establishing rhabdomyolysis. Literature on rhabdomyolysis in transplanted patients is reviewed. Therapeutic choices in transplanted patients needing concomitant therapy with azole and statin are discussed.