NECROTIZING MYOPATHY DUE TO CHOLESTEROL-L OWERING AGENTS - A CASE-REPORT AND REVIEW OF THE LITERATURE

A 73 year old male who had been prescribed fenofibrate for years devel oped a slightly asymmetric paraparesis of both lower extremities. CPK values rose to 9800 U/l, EMG of the quadriceps femoris muscle was myop athic. Muscle biopsy revealed a necrotic myopathy. Discontinuation of fenofibrate induced a rapid decline of CPK values, followed by a slowe r remission of muscular symptoms and persisting pseudomyotonic dischar ges in EMG. The spectrum of neuromuscular side effects of cholesterol lowering agents, consisting of myalgia, cramps and reversible CPK elev ation, is discussed. Only rarely necrotic myopathies have been describ ed.