Rhabdomyolysis and acute renal failure induced by combination lovastatin and gemfibrozil therapy

Article Abstract:

Lovastatin is a drug that decreases levels of blood lipids, or fats, and is used to treat hypercholesterolemia, or abnormally high blood cholesterol levels. This lipid-lowering agent inhibits an enzyme involved in the production of cholesterol. Lovastatin has few adverse side effects, but was shown to cause myopathy, or muscle pain and weakness in 0.5 percent of patients. Lovastatin may cause rhabdomyolysis, the destruction of skeletal muscle, when combined with agents that suppress the immune system, such as cyclosporine. Lovastatin may also cause myopathy when the drugs gemfibrozil, nicotinic acid, or erythromycin are taken concurrently. A case is described of a 63-year-old male who developed rhabdomyolysis and sudden kidney failure after receiving lovastatin and gemfibrozil, another lipid-lowering agent used to treat hypercholesterolemia. It is not clear how these two agents interact to cause rhabdomyolysis and sudden kidney failure, but this combination of drugs must be used with caution, particularly in patients with several medical problems who are receiving multiple medications. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Case studies, Drug therapy, Striated muscle, Hypercholesterolemia, Drug interactions, Gemfibrozil, Lovastatin, Rhabdomyolysis

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Diagnosing vascular causes of renal failure

Article Abstract:

Many conditions or diseases of the blood vessels in and around the kidney can cause kidney failure. Researchers reviewed the symptoms and techniques to identify various kidney conditions that can cause kidney failure. Taking medications including cyclosporine and nonsteroidal anti-inflammatory drugs, having liver failure, and low salt levels in the urine can contribute to low blood pressure that may impair the filtration function of the kidney. Blood-flow measurements taken in the kidney can confirm impaired filtration functioning. Obstructions in the kidney's large and small blood vessels can also develop causing kidney failure. Doctors can typically identify small vessel obstructions by biopsy, blood, urine, and blood pressure tests, or by observing the patient's additional symptoms. They can confirm the presence of obstructions in the large blood vessels supplying the kidney by arteriography, kidney biopsy, sonograms, other imaging techniques, or by treating underlying high blood pressure.

Chronic kidney failure, Blood circulation disorders, Vascular diseases

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Recurrent pancytopenia, coagulopathy, and renal failure associated with multiple quinine-dependent antibodies

Article Abstract:

Treatment with quinine may cause the development of antibodies that attack different types of red blood cells, blood platelets and neutrophils. A 41-year-old woman was admitted to the hospital with nausea, abdominal pain and fever. She had had four similar episodes starting after she first took a drug that contained quinine for leg cramps. These episodes were characterized by low blood pressure, a deficiency of all cellular elements of the blood, blood clotting abnormalities and kidney failure. A 65-year-old woman was admitted to the hospital for recurrent episodes of nausea, vomiting and fever. She also had low blood pressure, decreased cellular elements of the blood, blood clotting abnormalities and kidney failure. She had taken quinine sulfate tablets for leg cramps. Quinine can be bought over-the-counter in some types of preparations. Its use should be restricted because of the risk of serious adverse reactions.

Blood clotting disorders, Blood coagulation disorders, Pancytopenia, Quinine

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