{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,12,13]],"date-time":"2024-12-13T05:22:09Z","timestamp":1734067329679,"version":"3.30.2"},"reference-count":42,"publisher":"Akademiai Kiado Zrt.","issue":"48","content-domain":{"domain":["akjournals.com"],"crossmark-restriction":true},"short-container-title":["OH"],"published-print":{"date-parts":[[2024,12,1]]},"abstract":"<jats:p>Mind a sztatinok, mind a nitrog\u00e9ntartalm\u00fa biszfoszfon\u00e1tok a mevalon\u00e1t-\u00fatvonalon\n                    hatnak. Egy\u00fcttes alkalmaz\u00e1suk eset\u00e9n nemcsak kedvez\u0151 hat\u00e1suk, hanem\n                    mell\u00e9khat\u00e1saik is \u00f6sszead\u00f3dhatnak. Rhabdomyolysis kialakul\u00e1s\u00e1nak lehet\u0151s\u00e9g\u00e9re\n                    jap\u00e1n szerz\u0151k m\u00e1r 2009-ben felh\u00edvt\u00e1k a figyelmet osteoporoticus n\u0151betegek\n                    lipidcs\u00f6kkent\u0151 kezel\u00e9sekor. Igen ritk\u00e1n ezt \u00e9szlelt\u00e9k kr\u00f3nikus sztatinkezel\u00e9s\n                    eset\u00e9n is, k\u00f6zvetlen\u00fcl biszfoszfon\u00e1t ad\u00e1s\u00e1t k\u00f6vet\u0151en. Az ismertetett esetben a\n                    k\u00e9t gy\u00f3gyszer egy\u00fcttes, kr\u00f3nikus alkalmaz\u00e1sa sor\u00e1n megjelen\u0151 myopathi\u00e1s\n                    t\u00fcneteket a rhabdomyolysis szintj\u00e9t megk\u00f6zel\u00edt\u0151 kreatin-kin\u00e1z-\u00e9rt\u00e9k k\u00eds\u00e9rte. A\n                    81 \u00e9ves n\u0151beteg 18 h\u00f3napos, 30 mg\/die d\u00f3zis\u00fa atorvasztatinkezel\u00e9st k\u00f6vet\u0151en 6\n                    h\u00f3napos \u00edz\u00fcleti panaszok, als\u00f3 v\u00e9gtagi izomf\u00e1jdalom \u00e9s izomgyenges\u00e9g miatt\n                    ker\u00fclt vizsg\u00e1latra, 5638 U\/l kreatin-kin\u00e1z- \u00e9s 2129 U\/l\n                    lakt\u00e1tdehidrogen\u00e1z-\u00e9rt\u00e9kekkel. Sztatin abbahagy\u00e1s\u00e1ra a klinikai t\u00fcnetek 6 h\u00e9ten\n                    bel\u00fcl megsz\u0171ntek, de a kreatin-kin\u00e1z-szint csak igen lassan cs\u00f6kkent, 5 h\u00f3nap\n                    eltelt\u00e9vel is m\u00e9g a norm\u00e1lis fels\u0151 hat\u00e9r\u00e9rt\u00e9k h\u00e9tszerese volt. Az euthyreoticus,\n                    nem diabeteses beteg el\u0151z\u0151leg 4 \u00e9ven \u00e1t <jats:italic>per os<\/jats:italic> alendron\u00e1t-,\n                    k\u00f6zel 1 \u00e9ven \u00e1t <jats:italic>per os<\/jats:italic> rizedron\u00e1tkezel\u00e9sben r\u00e9szes\u00fclt (az\n                    ut\u00f3bbit az \u00e9szlel\u00e9st k\u00f6vet\u0151en is kapta), mindv\u00e9gig folyamatos kalcium- \u00e9s\n                    D-vitamin-p\u00f3tl\u00e1ssal. \u00cdgy a magas kreatin-kin\u00e1z-szint kialakul\u00e1s\u00e1\u00e9rt \u00e9s annak\n                    igen lass\u00fa cs\u00f6kken\u00e9s\u00e9\u00e9rt sztatin-biszfoszfon\u00e1t k\u00f6lcs\u00f6nhat\u00e1s lehetett a felel\u0151s.\n                    B\u00e1r a norm\u00e1lis fels\u0151 hat\u00e1r\u00e9rt\u00e9k 18-szoros\u00e1t el\u00e9r\u0151 kreatin-kin\u00e1z-szint\n                    k\u00f6vetkezetesen norm\u00e1lis vesefunkci\u00f3 mellett a jelen ir\u00e1nyelvek szerint nem felel\n                    meg rhabdomyolysisnek, az 5000 NE\/l feletti szintet rizik\u00f3faktornak tekintik\n                    rhabdomyolysis kialakul\u00e1s\u00e1ra, egy\u00e9b kiv\u00e1lt\u00f3ok keres\u00e9s\u00e9re, azt is felt\u00e9telezve,\n                    hogy a beteg nem alkalmas sztatinkezel\u00e9sre. A betegn\u00e9l hyperlipidaemi\u00e1n k\u00edv\u00fcl\n                    m\u00e1s cardiovascularis rizik\u00f3faktor nem \u00e1llt fenn, \u00edgy a sztatin folytat\u00e1sa n\u00e9lk\u00fcl\n                    89 \u00e9ves kor\u00e1ban halt meg, gyomorperfor\u00e1ci\u00f3-m\u0171t\u00e9tj\u00e9t k\u00f6vet\u0151en. Eset\u00fcnk azt a\n                    k\u00fcl\u00f6nleges helyzetet mutatja be, amikor a k\u00e9t, mevalon\u00e1t-\u00fatvonalon hat\u00f3\n                    gy\u00f3gyszer a m\u00e9g fiziol\u00f3gi\u00e1s m\u00e9rt\u00e9k\u0171nek sz\u00e1nd\u00e9kolt enzimhat\u00e1st patofiziol\u00f3gi\u00e1ss\u00e1\n                    ford\u00edtja, hasonl\u00f3an ahhoz, amikor egy\u00fcttes alkalmaz\u00e1suk nem v\u00e1rtan patol\u00f3gi\u00e1s\n                    csontt\u00f6r\u00e9st okozott a cs\u00f6kkent szteroidszint\u00e9zis miatt. Orv Hetil. 2024;\n                    165(48): 1911\u20131916.<\/jats:p>","DOI":"10.1556\/650.2024.33138","type":"journal-article","created":{"date-parts":[[2024,12,1]],"date-time":"2024-12-01T08:42:17Z","timestamp":1733042537000},"page":"1911-1916","update-policy":"https:\/\/doi.org\/10.1556\/policypage.crossmark.crossref.2","source":"Crossref","is-referenced-by-count":0,"title":["Magas kreatin-kin\u00e1z-szint igen lass\u00fa cs\u00f6kken\u00e9se sztatin elhagy\u00e1s\u00e1t k\u00f6vet\u0151en a myopathi\u00e1s klinikai t\u00fcnetek gyors javul\u00e1s\u00e1val, osteoporosisban szenved\u0151 id\u0151s n\u0151betegben"],"prefix":"10.1556","volume":"165","author":[{"given":"L\u00e1szl\u00f3","family":"Szende","sequence":"first","affiliation":[{"name":"Veresegyh\u00e1zi Misszi\u00f3 Eg\u00e9szs\u00e9g\u00fcgyi K\u00f6zpont, Rehabilit\u00e1ci\u00f3s Oszt\u00e1ly Veresegyh\u00e1z, Gyermekliget u. 30., 2112 Magyarorsz\u00e1g"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"425","reference":[{"key":"ref0","doi-asserted-by":"publisher","first-page":"781","DOI":"10.1211\/jpp.61.06.0011","article-title":"Synergistic action of statins and nitrogen-containing bisphosphonates in the development of rhabdomyolysis in L6 rat skeletal myoblasts","volume":"61","author":"1 Nishiguchi","year":"2009","unstructured":"1 Nishiguchi T, Akiyoshi T, Anami S, et al. Synergistic action of statins and nitrogen-containing bisphosphonates in the development of rhabdomyolysis in L6 rat skeletal myoblasts. J Pharm Pharmacol. 2009; 61: 781-788.","journal-title":"J Pharm Pharmacol"},{"key":"ref1","unstructured":"2 Basseri B, White MB. Alendronate-associated rhabdomyolysis in a patient with other risk factors. Fed Pract. 2009; 26: 33-37."},{"key":"ref2","doi-asserted-by":"publisher","unstructured":"3 Schaefer MW, Gopalakrishnan G. Rhabdomyolysis associated with intravenous zoledronic acid infusion for the treatment of postmenopausal osteoporosis. 92nd Annual Meeting of the Endocrine Society: abstr. P2-205, 19 Jun 2010. Available from: http:\/\/www.endo-society.org [accessed: 2 July, 2024].","DOI":"10.1210\/endo-meetings.2010.PART2.P5.P2-205"},{"key":"ref3","unstructured":"4 Guney E, Kisakol G, Ozgen AG, et al. Effects of bisphosphonates on lipid metabolism. 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