Non-Steroidal Anti-Inflammatory, Rhabdomyolysis, and Hemolysis: A Rare Complication of Commonly Used Drugs

Abstract

Nonsteroidal anti-inflammatory drug (NSAID)-induced hemolytic anemia (DIIHA) and rhabdomyolysis is a rare but notable issue, especially for patients with chronic kidney disease (CKD). While NSAIDs are known for causing gastrointestinal and renal effects, hemolysis-elated and muscle necrosis cases are often overlooked. Patients with CKD, who often take numerous medications, have shifts in how drugs are metabolized, making them more vulnerable to these reactions. We present a case of a 33-year-old man, who has no significant medical illness, and who developed DIIHA and rhabdomyolysis, after taking dexketoprofen, requiring dialysis to preserve his renal function. He showed fatigue, abdominal pain, and dark brown urine. Tests showed high creatinine levels, creatine kinase (CK), and low hemoglobin. Blood gas analysis pointed to metabolic acidosis, possibly due to hemolysis and uremia. Stopping dexketoprofen and providing supportive care, like hydration and blood transfusions, led to better health outcomes. This case highlights the importance of monitoring drug use in vulnerable groups and the need for quick identification and treatment of drug-related blood disorders, particularly among high-risk patients.