title: Myoglobinuria and COX deficiency in a patient taking cerivastatin and gemfibrozil.
abstract: 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.
authors.affiliation: Centro de Investigación, Hospital Universitario 12 de Octubre, Madrid, Spain. jarenas@h12o.es
authors.forename: J
authors.initials: J
authors.lastname: Arenas
authors.forename: M A
authors.initials: MA
authors.lastname: Fernández-Moreno
authors.forename: J A
authors.initials: JA
authors.lastname: Molina
authors.forename: V
authors.initials: V
authors.lastname: Fernández
authors.forename: P
authors.initials: P
authors.lastname: del Hoyo
authors.forename: Y
authors.initials: Y
authors.lastname: Campos
authors.forename: P
authors.initials: P
authors.lastname: Calvo
authors.forename: M A
authors.initials: MA
authors.lastname: Martín
authors.forename: A
authors.initials: A
authors.lastname: García
authors.forename: T
authors.initials: T
authors.lastname: Moreno
authors.forename: A
authors.initials: A
authors.lastname: Martínez-Salio
authors.forename: B
authors.initials: B
authors.lastname: Börnstein
authors.forename: F
authors.initials: F
authors.lastname: Bermejo
authors.forename: A
authors.initials: A
authors.lastname: Cabello
authors.forename: R
authors.initials: R
authors.lastname: Garesse
mesh_terms: 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*
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D000960:Hypolipidemic Agents; D011725:Pyridines; C086276:cerivastatin; D015248:Gemfibrozil