Cytoskeletal myotoxicity from simvastatin and colchicine
Steven K. Baker MSc, MD
Departments of Pediatrics and Medicine, McMaster University Medical Center, Hamilton, Ontario L8N 3Z5, Canada
Search for more papers by this authorSusan Goodwin MD
Department of Medicine, St. Joseph's Hospital, Hamilton, Ontario, Canada
Search for more papers by this authorMonalisa Sur MD
Department of Pathology, Hamilton General Hospital, McMaster University, Hamilton, Ontario, Canada
Search for more papers by this authorCorresponding Author
Mark A. Tarnopolsky MD, PhD
Departments of Pediatrics and Medicine, McMaster University Medical Center, Hamilton, Ontario L8N 3Z5, Canada
Departments of Pediatrics and Medicine, McMaster University Medical Center, Hamilton, Ontario L8N 3Z5, CanadaSearch for more papers by this authorSteven K. Baker MSc, MD
Departments of Pediatrics and Medicine, McMaster University Medical Center, Hamilton, Ontario L8N 3Z5, Canada
Search for more papers by this authorSusan Goodwin MD
Department of Medicine, St. Joseph's Hospital, Hamilton, Ontario, Canada
Search for more papers by this authorMonalisa Sur MD
Department of Pathology, Hamilton General Hospital, McMaster University, Hamilton, Ontario, Canada
Search for more papers by this authorCorresponding Author
Mark A. Tarnopolsky MD, PhD
Departments of Pediatrics and Medicine, McMaster University Medical Center, Hamilton, Ontario L8N 3Z5, Canada
Departments of Pediatrics and Medicine, McMaster University Medical Center, Hamilton, Ontario L8N 3Z5, CanadaSearch for more papers by this authorAbstract
We report the case of a 79-year-old man with mild chronic renal failure who developed severe rhabdomyolysis after combined exposure to simvastatin and colchicine. Colchicine induces myopathy through disruption of microtubular function with subsequent vacuolization and pseudomyelinic body accumulation. Statin therapy is associated with myonecrosis, membranous myeloid bodies, and vacuolization, presumably as a function of impaired isoprenoid metabolism. Vesicle trafficking requires small G-protein prenylation and statins can disrupt cytoskeletal integrity. We propose that synergistic cytoskeletal myotoxicity may account for the extreme elevation of serum creatine kinase not previously reported in pure colchicine myopathy. Muscle Nerve, 2004
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