English (United Kingdom)

https://curated-unify.zendy.io/wp-json/zendy-region/v1/featured_content/oa?rat=en

https://curated-unify.zendy.io/wp-json/zendy-region/v1/highlighted_journal/

Global: Zendy Plus annual

Presents the access of premium content as premium feature

Premium Content

Presents the keyphrase highlighting as premium feature

Keyphrase Highlighting

Presents the summarisation as premium feature

Summarisation

Insights

Presents the pdf analysis as premium feature

PDF Analysis

Presents the zaia usage as premium feature

ZAIA

Global: Zendy Plus monthly

Global: Zendy Tools annual

Global: Zendy Tools monthly

Global: Zendy Free Plan

Dr. G. Fernández Zataraín, Servicio de Nefrología, Hospital General de Castellón, Avenida de Benicasim, s/n, E-12004 Castellón (Spain) Dear Sir, Lovastatin is an inhibitor of 3-hydroxy-3-methylglutaryl coenzyme A reductase with known efficiency [1] and few adverse effects, usually mild [1, 2]. Rhabdomyolysis is exceptional and is nearly always associated with other drugs that increase lovastatin levels or can produce rhabdomyolysis by themselves: cyclosporine A [3-5], gemfibrozil [4,6-8], ery-thromycin [9], nicotinic acid [10]. We present a case of severe rhabdomyolysis with acute renal failure (ARF) and hepatopathy during low-dose lovastatin treatment without known drug interactions. A 65-year-old woman with hyperlipide-mia, hypertension, coronariopathy and mild renal insufficiency was receiving aspirin (125 mg/day), nitrites (20 mg/8 h) and quinapril (20 mg/day). Later, lovastatin (20 mg/day) was added. Two weeks later, she noticed diffuse myalgias and progressive strength loss as well as dark urine. A week later, after no improvement with nonsteroidal anti-inflammatory drug and vitamins, she came to our center with anuria and immobility. There was no history of other drugs, toxics or alcohol ingestion, violent exercises or infectious or systemic symptomatology. Exploration showed blood pressure 150/80 mm Hg, central venous pressure 0 cm of water, dehydrated skin and mucoses and no fever. Muscular masses were painful at palpation with generalized decrease in strength. The rest of the neurological exploration was normal. Laboratory data were: urea 28.02 mmol/l (168 mg/dl), Cr 371 μmol/l (4.2 mg/dl), K+ 6.5 mmol/l (6.5 mEq/1), Ca2+ 2.44 mmol/l (9.8 mg/dl), P 1.9 mmol/l (6.1 mg/dl), glucose 5.78 mmol/l (105 mg/dl), uric acid 463.94 μmol/l (7.8 mg/dl), bicarbonate 18.7 mmol/l (18.7 mEq/1). Maximal enzime values were: cre-atine kinase > 1,667 μmol/l ( > 100,000 U/l), CK-MB 5%, myoglobin > 41,000 pg/l ( > 41,000 ng/ml), aldolase > 4,167 nkat/1 ( > 250 U/l), aspartate aminotransferase 22.43 μkat/1 (1,346 U/l), alanine aminotransferase 11.3 μkat/1 (678 U/l), γ-glutamyl trans-peptidase 0.88 μkat/1 (53 U/l), lactate dehy-drogenase 104.42 μkat/1 (6,264 U/l), alkaline phosphatase 2.90 μkat/1 (174 U/l), bilirubin 8.55 μmol/l (0.5 mg/dl). Prothrombin-activ-ity was 69%, prothrombin time 16.5/13.9. Ery-throcyte and platelet count were normal, with 11.6 × 1071 (11,600 × lOVμl) leukocytes. Urine was dark with colorimetric reaction for blood (+ + +), 10-12

Rhabdomyolysis and Acute Renal Failure Associated with Lovastatin