Rhabdomyolysis Associated With Febuxostat in a Non-Chronic Kidney Disease (CKD) Patient: Diagnostic and Management Challenges.

Rhabdomyolysis is a critical medical condition characterized by the rapid breakdown of muscle tissue, releasing substances such as myoglobin and creatine kinase into the bloodstream, potentially leading to acute kidney injury. The etiology includes trauma, exertion, genetic factors, infections, and adverse drug reactions. Febuxostat, a non-purine selective xanthine oxidase inhibitor used to manage hyperuricemia in gout patients, is typically well-tolerated but has been associated with rare instances of severe adverse reactions like rhabdomyolysis. This case report describes a case of a 73-year-old male who developed rhabdomyolysis shortly after initiating febuxostat for gout management. He presented with significant lower back pain and progressive leg weakness, initially suspected to be an exacerbation of his degenerative disk disease. Laboratory findings revealed alarmingly elevated creatine phosphokinase levels, and diagnostics excluded other potential etiologies. The patient's condition significantly improved following the cessation of febuxostat and initiation of supportive care, including high-dose intravenous corticosteroids and hydration. This case underscores the need for vigilance in monitoring for rhabdomyolysis in patients starting febuxostat, especially when presenting with unexplained muscle weakness or pain.