Myoglobinuria and COX deficiency in a patient taking cerivastatin and gemfibrozil.
The authors describe a patient who presented with myoglobinuria after starting cerivastatin-gemfibrozil therapy. Muscle histochemistry revealed ragged-red fibers and cytochrome c oxidase negative (COX) fibers, and biochemistry showed a defect of COX activity. Immunoblot analysis showed a 60% reduction of COX I and COX II polypeptides. Cerivastatin myotoxicity might be related to a depletion of essential metabolites needed to anchor COX subunit I to mitochondrial membrane.
Arenas
J
J
Centro de Investigación, Hospital Universitario 12 de Octubre, Madrid, Spain. jarenas@h12o.es
Fernández-Moreno
M A
MA
Molina
J A
JA
Fernández
V
V
del Hoyo
P
P
Campos
Y
Y
Calvo
P
P
Martín
M A
MA
García
A
A
Moreno
T
T
Martínez-Salio
A
A
Börnstein
B
B
Bermejo
F
F
Cabello
A
A
Garesse
R
R
D000368:Aged; D001706:Biopsy; D030401:Cytochrome-c Oxidase Deficiency / Q000139:chemically induced* / Q000175:diagnosis; D005260:Female; D015248:Gemfibrozil / Q000009:adverse effects*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000009:adverse effects*; D000960:Hypolipidemic Agents / Q000009:adverse effects*; D018656:Muscle Fibers, Fast-Twitch / Q000201:enzymology / Q000473:pathology; D018908:Muscle Weakness / Q000209:etiology; D018482:Muscle, Skeletal / Q000187:drug effects / Q000201:enzymology / Q000473:pathology; D009212:Myoglobinuria / Q000139:chemically induced* / Q000175:diagnosis / Q000503:physiopathology; D010146:Pain / Q000209:etiology; D011725:Pyridines / Q000009:adverse effects*
D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D000960:Hypolipidemic Agents; D011725:Pyridines; C086276:cerivastatin; D015248:Gemfibrozil