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Cerivastatin과 Cyclosporine을 병용 투약한 신이식 환자에서의 횡문근융해증 1예
신성훈,김민대,강승수,김찬욱,이지영,엄재섭,권성일,김길수,정연순,임학 고신대학교 의학부 2002 高神大學校 醫學部 論文集 Vol.17 No.1
Cerivastatin, a kind of statins, is a recently used lipid-lowering drug. which inhibits of hydroxymethylglutarate coenzyme A (HMG-CoA) reductase. The serum concentrations of statins in healthy volunteers are increased by the simultaneous administration of cyclosporine, itraconazole, as well as erythromycin and verapamil and increased risk of myalgia and rhabdomyolysis has been reported after concomitant use of HMG-CoA reductase inhibitors with these drugs. A 57-year-old female kidney transplant recipient admitted because of a dark urine, myalgia and weakness of extremities. Six weeks before admission, the patient has taken cerivastatin 0.3mg daily. Cyclosporine, prednisolone and mycophenolate mofetil were maintained for recent two years. Initial laboratory data showed serum creatinine 1.1mg/dl, AST 235 IU/L, LDH 2,465 IU/L, CPK 1600 IU/L, myoglobin >3,000 ng/ml and cyclosporine 288ng/ml (TDX). Medication of cerivastatin was discontinued, and the patient recovered rapidly with supportive therapy. After eighteen weeks of cerivastatin withdrawal. the drug was represcribed to control the increased lipid levels. The patient showed the same clinical manifestations suggesting rhabdomyolysis following eight weeks of cerivastatin administration. We report a case of rhabdomyolysis associated with cerivastatin and cyclosporine combination therapy in a kidney transplant recipient.