title: Fluoroquinolone-induced serious, persistent, multisymptom adverse effects.
abstract: We present a case series of four previously healthy, employed adults without significant prior medical history in each of whom symptoms developed while on fluoroquinolones (FQs), with progression that continued following discontinuation evolving to a severe, disabling multisymptom profile variably involving tendinopathy, muscle weakness, peripheral neuropathy, autonomic dysfunction, sleep disorder, cognitive dysfunction and psychiatric disturbance. Physicians and patients should be alert to the potential for FQ-induced severe disabling multisymptom pathology that may persist and progress following FQ use. Known induction by FQs of delayed mitochondrial toxicity provides a compatible mechanism, with symptom profiles (and documented mechanisms of FQ toxicity) compatible with the hypothesis of an exposure-induced mitochondrial neurogastrointestinal encephalomyopathy.
authors.affiliation: Department of Medicine, University of California, San Diego, La Jolla, California, USA.
authors.forename: Beatrice Alexandra
authors.initials: BA
authors.lastname: Golomb
authors.affiliation: Department of Medicine, University of California, San Diego, La Jolla, California, USA.
authors.forename: Hayley Jean
authors.initials: HJ
authors.lastname: Koslik
authors.affiliation: Department of Anthropology, University of Kansas, Lawrence, Kansas, USA.
authors.forename: Alan J
authors.initials: AJ
authors.lastname: Redd
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000009:adverse effects*; D004823:Epididymitis / Q000188:drug therapy*; D005260:Female; D024841:Fluoroquinolones / Q000008:administration & dosage / Q000009:adverse effects*; D006801:Humans; D007049:Iatrogenic Disease; D008297:Male; D008875:Middle Aged; D017237:Mitochondrial Encephalomyopathies / Q000139:chemically induced* / Q000503:physiopathology; D010254:Paranasal Sinus Diseases / Q000188:drug therapy*; D010612:Pharyngitis / Q000188:drug therapy*; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D024841:Fluoroquinolones