COLCHICINE MYOPATHY IN RENAL-TRANSPLANT RECIPIENTS ON CYCLOSPORINE

Few data are available about the muscle status in renal transplant rec ipients. Moreover, the list of myotoxic drugs is growing longer and so me of them are likely to be prescribed in renal transplant patients. T hese conditions may act as confounding factors in case reports of both cyclosporin and colchicine myopathies. Moreover no study has evaluate d the frequency of myopathy in patients on both colchicine and cyclosp orin. We conducted a retrospective study including all renal transplan t recipients followed in our unit in whom colchicine was prescribed si nce January 1994. Clinical and biological data of patients on both col chicine and cyclosporin were analysed. Secondly case subjects were com pared with matched controls not receiving colchicine but cyclosporin. Ten patients received colchicine in association with cyclosporin. Five patients (50%) experienced muscular symptoms and when performed, musc ular histology showed vacuolar myopathy. All five patients improved af ter colchicine withdrawal. Cases with and without muscular symptoms di d not differ in age, transplant duration, and serum creatinine level. Mean duration of colchicine therapy was 12.2+/-4.4 months in cases wit h muscular symptoms and 6.8+/-4.6 months in cases without muscular sym ptoms (P<0.05). No control complained of either muscular pain nor weak ness (P<0.0005). Only one patient (3.3%) had elevated serum creatine p hosphokinase concentration (P<0.0005). We conclude that myopathy is ve ry frequent in patient on both colchicine and cyclosporin. Muscular sy mptoms improve in all patients after colchicine withdrawal.