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Rhabdomyolysis and hepatotoxicity: case report A 13-year-old girl developed hepatotoxicity during treatment with rosuvastatin and lovastatin. Additionally, she developed rhabdomyolysis secondary to rosuvastatin [routes and dosages not stated; not all durations of treatments to reactions onset stated]. The girl was diagnosed with ROHHAD syndrome at the age of 4 years. Later, she was found to have pan-hypopituitarism and was treated with unspecified vasopressins [antidiuretic-hormones], levothyroxine-sodium [levothyroxine] and hydrocortisone replacements. She developed mixed dyslipidemia at the age of 5 years, and was treated with lovastatin, niacin and fish oil. She tolerated the treatment for approximately 8 years. In addition to hyperlipidemia, she also noted to have hepatic steatosis with elevated transaminase levels (AST 162 IU/L and ALT 72I U/L). She had been receiving metformin for prediabetes since 12 years of age. Subsequently, the dose of lovastatin was escalated. The woman’s hyperlipidaemia persisted despite the dose escalation of lovastatin. Therefore, lovastatin was switched to rosuvastatin, and she continued treatment with fish oil. Within 2 weeks from the initiation of rosuvastatin, she presented with hypernatraemia, hyperchloraemia, acute kidney injury, 3+ blood with only 1 RBC on urinalysis and highly elevated creatine phosphokinase. All these findings suggested acute rhabdomyolysis secondary to rosuvastatin. Her acutely increased transaminases (AST 558 IU/L and ALT 298 IU/L) were consistent with statin induced hepatitis. Thus, rosuvastatin was stopped, and she received unspecified hydration therapy. Within a week, her creatine phosphokinase normalised. Eventually, her AST and ALT levels improved. Later, metformin was stopped, and she was continued on fish oil and healthy lifestyle changes. Later, it was noted the hepatotoxicity was associated with rosuvastatin and lovastatin. Vijayakanthi N, et al. Rhabdomyolysis due to rosuvastatin in a patient with ROHHAD syndrome-a case report. Hormone Research in Paediatrics 93 (Suppl.): 28-29 (plus 803505958 poster) abstr. 36, Jul 2020. Available from: URL: http://doi.org/10.1159/000509566 [abstract]

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Reactions 10 Oct 2020 No. 1825