HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Jose, J. Articles by Shastry, B. A. Search for Related Content PubMed PubMed Citation Articles by Jose, J. Articles by Shastry, B. A.

JIMMY JOSE, M.PHARM., is Lecturer, Department of Pharmacy Practice, Manipal College of Pharmaceutical Sciences; KAVITHA SARAVU, M.D./DNB, is Associate Professor, Department of Medicine, Kasturba Hospital; and BARKUR ANATHAKRISHNA SHASTRY, M.D., is Professor, Department of Medicine, Kasturba Hospital, Manipal Academy of Higher Education, Manipal, Karnataka, India.

Address correspondence to Mr. Jose at the Department of Pharmacy Practice, Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education, Manipal, Karnataka 576104, India (jimmy_jose2001{at}yahoo.com).

Purpose. A case of early-onset rhabdomyolysis in a patient treated with atorvastatin is described. Summary. A 17-year-old Indian boy weighing 55 kg was admitted to the hospital after complaining of facial puffiness and pedal edema for four days. His medical history revealed a diagnosis of nephrotic syndrome when he was 2 years old. He had six relapses, the last of which occurred 10 years ago. He was not taking any medications on admission and had not for the past 9 years. His vital signs were normal on admission (day 1), but anasarca was noticed during general examination. Cardiovascular, respiratory, and abdominal examinations were normal. Relapse of nephrotic syndrome was considered, and his 24-hour urine protein value confirmed the diagnosis. Further laboratory tests revealed that the patient had high total and low-density-lipoprotein cholesterol values (597 and 465 mg/dL, respectively), and atorvastatin 10 mg p.o. once daily was initiated on day 2. Prednisolone 60 mg p.o. once daily was initiated on day 3. On day 6, the patient complained of pain in both thighs and had difficulty walking. His creatine kinase (CK) concentration was then measured and found to be elevated (11,821 IU/L). Prednisolone and atorvastatin were then stopped, as statin-induced myopathy was suspected. The patient received i.v. hydration and sodium bicarbonate, and he began to show improvement by day 9. Follow-up three weeks later revealed a normal CK level and no myopathy-related complaints. Conclusion. Early-onset rhabdomyolysis was reported in a patient with nephrotic syndrome who was treated with atorvastatin. Concomitant use of prednisolone and the patient’s underlying renal impairment may have predisposed the patient to this adverse reaction. Index terms: Adolescents; Alkalinizing agents; Antilipemic agents; Atorvastatin; Nephrotic syndrome; Prednisolone; Rhabdomyolysis; Sodium bicarbonate; Toxicity