Rosuvastatin
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Ischaemic colitis: case report A 64-year-old woman developed ischaemic colitis during treatment with rosuvastatin [Crestor] for cholesterol control. The woman presented with sudden-onset bilateral lower abdominal pain associated with eight bouts of bloody diarrhoea. She was hypertensive, diaphoretic, and observed to have tachypnoea. Four weeks earlier, she had undergone a colonoscopy, which was normal except for pre-existing diverticular disease. She had recently been started on rosuvastatin [dosage, duration of therapy and route not stated] for cholesterol control. She had reported a similar episode of abdominal pain with bloody diarrhoea after starting rosuvastatin about 1 year ago, but did not seek medical attention. She had stopped the drug of her own accord, and the pain had resolved. On this occasion, initial blood testing in the emergency department revealed an elevated WBC count (16.8 × 109/L), of which neutrophil count was 14.6 × 109/L. Her haemoglobin level was 161 g/L, and her C-reactive protein level was < 1.0 mg/L. Evident on abdominal CT was a long segment of colon wall thickening indicative of colitis from splenic flexure to proximal sigmoid colon. The only identifiable change to her medication regimen was the addition of rosuvastatin. Rosuvastatin was temporarily withdrawn on the ward. The woman was managed with IV fluids and bowel rest, and her symptoms gradually resolved over 3 days. A colonoscopy revealed mucosal ulceration and diverticulosis, and histology of biopsies taken demonstrated an ischaemic colitis picture. The final histological diagnosis was ischaemic colitis secondary to a rare adverse drug reaction. She was reviewed following discharge, and reported to be in complete remission 2 weeks after discontinuing rosuvastatin. Author comment: "This patient’s recent normal colonoscopy 4 weeks before presentation, and her recent commencement of rosuvastatin is a strong temporal indicator that rosuvastatin is responsible for her case of non-occlusive, non-infective ischaemic colitis". Tan J, et al. Adverse drug reaction: Rosuvastatin as a cause for ischaemic colitis in a 64-year-old woman. BMJ Case Reports : 2012. Available from: URL: http:// 803077864 dx.doi.org/10.1136/bcr.11.2011.5270 - Australia
0114-9954/10/1422-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
Reactions 6 Oct 2012 No. 1422
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