Abstract
Case 1 : A 54-year-old woman on maintenance hemodialysis for chronic interstitial nephritis developed cystitis and received oral levofloxacin (LVFX). Four days later, she developed severe pain in her bilateral Achilles tendon and bilateral extensor and flexor tendons of the thumb. We diagnosed LVFX-induced tendinopathy. Two months after the discontinuation of LVFX, pain of the upper limbs improved, and all symptoms had disappeared completely four months later. Case 2 : A 79-year-old man on maintenance peritoneal dialysis for chronic glomerulonephritis had taken oral steroid for eosinophilic peritonitis. He received oral LVFX due to peritoneal dialysis-associated peritonitis. Four days later, he developed severe pain in his right Achilles tendon. Magnetic resonance imaging revealed Achilles tendon rupture, so achillorrhaphy was performed. Unfortunately, two months after surgery, Achilles tendon rupture relapsed. Case 3 : An 82-year-old man on maintenance hemodialysis for hypertensive nephrosclerosis developed sepsis and received oral LVFX. The next day, bilateral Achilles tendon pain appeared and persisted for two weeks under LVFX therapy. This pain disappeared one week after the withdrawal of LVFX. Fluoroquinolone-induced tendinopathy is less well known and has risk factors such as old age, steroid use, and chronic renal failure.
