FIBRATE-INDUCED RHABDOMYOLYSIS WITH MYOGL OBINEMIA AND TRANSIENT RENAL-FAILURE IN A PATIENT WITH MYOPATHY DUE TO HYPOTHYROIDISM

Administration of a lipid-lowering fibrate to a patient with unrecogni zed hypothyroidism was followed by severe rhabdomyolysis with transien t renal failure due to high serum myoglobin levels. Full recovery occu rred after discontinuation of the fibrate, despite a subtherapeutic do se of levothyroxine, suggesting that the rhabdomyolysis was drug-induc ed. Evidence of mild hypothyroidism-related myopathy was found. This c ase is additional evidence that fibrates can cause muscular toxicity a nd that thyroid function should be evaluated in patients with high ser um cholesterol levels and suggestive clinical symptoms.