Open AccessRhabdomyolysis due to red yeast rice (Monascus purpureus) in a renal transplant recipient
Author(s) -
G. V. Ramesh Prasad,
Timothy L. Wong,
Galo Meliton,
Salma Bhaloo
Publication year - 2002
Publication title -
transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.45
H-Index - 204
eISSN - 1534-6080
pISSN - 0041-1337
DOI - 10.1097/00007890-200210270-00028
Subject(s) - monascus purpureus , red yeast rice , lovastatin , rhabdomyolysis , yeast , hyperlipidemia , statin , biology , food science , complication , medicine , biochemistry , fermentation , gastroenterology , cholesterol , endocrinology , monascus , diabetes mellitus
Rhabdomyolysis is a known complication of hepatic 3-methylglutaryl coenzyme A reductase (HMG-CoA) inhibitor (statin) therapy for posttransplant hyperlipidemia, and thus monitoring for this effect is indicated. We report a case of an herbal preparation-induced rhabdomyolysis in a stable renal-transplant recipient, attributed to the presence of red yeast rice (Monascus purpureus) within the mixture. The condition resolved when consumption of the product ceased. Rice fermented with red yeast contains several types of mevinic acids, including monacolin K, which is identical to lovastatin. We postulate that the interaction of cyclosporine and these compounds through the cytochrome P450 system resulted in the adverse effect seen in this patient. Transplant recipients must be cautioned against using herbal preparations to lower their lipid levels to prevent such complications from occurring.