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당뇨병 환자에서 발생한 Cerivastatin에 의한 횡문근 융해증 3예
이성수 ( Lee Seong Su ),조유경 ( Jo Yu Gyeong ),김해림 ( Kim Hae Lim ),박훈준 ( Park Hun Jun ),박만원 ( Park Man Won ),최민석 ( Choe Min Seog ),이강우 ( Lee Gang U ),장윤식 ( Jang Yun Sig ),방병기 ( Bang Byeong Gi ) 대한신장학회 2001 Kidney Research and Clinical Practice Vol.20 No.6
Cerivastatin is novel HMG-CoA reductase inhibitors. Clinical trials showed no significant differences of serum creatine kiase between cerivastatin and placebo, and cerivastatin-induced myopathy was rarely reported. This beneficial effect of cerivastatin is thought to be related to the the dual pathway metabolism by hapatic CYP3A4 and 2C8. We here report three cases of rhabdomyolysis which is associated with cerivastatin therapy. Two patients had diabetes mellitus, and received cerivastatin( 0.8 mg/day) for treating hyperlipidemia and the other patient had chronic renal failure due to diabetic nephropathy and has maintained peritoneal dialysis and received cerivastatin(0.4 mg/day). Within one month of cerivastatin treatment, those patients experienced myalgia or muscle weakness. At that time, laboratory findings including muscle enzyme level, and bone scan finding were compatible with rhadomyolysis. Under the impression of cerivastatininduced rhabodmyolysis, cerivastatin was withdrwan, and conventional treatment for rhabdomyolysis was started. Clinical course was uneventful, and these patients were discharged with good general condition. In conclusion, cerivastatin is regarded as a safe drug as compared with other statins, but it also causes rhabdomyolysis. Careful history taking and regular follow-up of muscle enzyme levels would be necessary to detect cerivastatin-induced rhabdomyolysis.
이관형,이광우,김재욱,조재완,손호영,손현식,윤건호,강성구,문성대,차봉연,박훈준,정정 대한내과학회 2001 대한내과학회지 Vol.61 No.2
$quot;Empty sella is defined as a sella which, regardless of its size, is completely or partly filled with cerebrospinal fluid (CSF), and is divided into two groups, primary or secondary. Secondary empty sella syndrome is associated with a prior surgery, radiation therapy or medical treatment of pituitary gland, and otherwise primary. The endocrine function of primary empty sella syndrome is usually normal, but sometimes, this syndrome is associated with complete or partial pituitary insufficiency and rarely pituitary hypersecretion. In the cases of hypersecretion of pituitary hormones, hyperprolactinemia, acromegaly and hypersecretion of adrenocorticotrophin (ACTH) has been reported. But, hypersecretion of ACTH is rarely reported. We describe a patient of primary empty sella syndrome combined with Cushing's disease. So we present this case with a review of the literature.(Korean J Med 61:178-183, 2001)$quot;