Myoglobinuria and COX deficiency in a patient taking cerivastatin and gemfibrozil

Neurology. 2003 Jan 14;60(1):124-6. doi: 10.1212/01.wnl.0000042050.85041.fb.

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.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Biopsy
  • Cytochrome-c Oxidase Deficiency / chemically induced*
  • Cytochrome-c Oxidase Deficiency / diagnosis
  • Female
  • Gemfibrozil / adverse effects*
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / adverse effects*
  • Hypolipidemic Agents / adverse effects*
  • Muscle Fibers, Fast-Twitch / enzymology
  • Muscle Fibers, Fast-Twitch / pathology
  • Muscle Weakness / etiology
  • Muscle, Skeletal / drug effects
  • Muscle, Skeletal / enzymology
  • Muscle, Skeletal / pathology
  • Myoglobinuria / chemically induced*
  • Myoglobinuria / diagnosis
  • Myoglobinuria / physiopathology
  • Pain / etiology
  • Pyridines / adverse effects*

Substances

  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • Hypolipidemic Agents
  • Pyridines
  • cerivastatin
  • Gemfibrozil