Atorvastatin과 Calcium Channel Blocker 사용 환자에서의 콜키신 유발 급성 근육병증: 증례보고의 사례

Abstract

Myopathy is a rare side effect of chronic colchicine therapy, most often occurring in patients with chronic renal failure. Colchicine and 3-hydroxy-3-methy-glutaryl coenzyme A (HMG-CoA) reductase inhibitors are well known to cause myopathy. We report the case of a patient with chronic renal failure who had been taking atorvastatin and calcium channel blocker and developed acute weakness 7 days after the initiation of colchicines therapy for gouty attack. A 58-year-old woman on colchicine 0.6 mg twice a day for 7 days, developed subacute onset of painless proximal muscle weakness with elevation of creatine phosphokinase (CPK) level. Nerve conduction studies revealed a mild axonal and demyelinating neuropathy affecting the arms and legs and needle electromyography showed non-specific findings indicating myopathy. After withdrawal of colchicine, serum CPK levels returned to normal and her weakness resolved over a period. In our patient, neurological toxicity was induced and accerlated by coadministration of colchicines with atorvastatin and calcium channel blocker in the presence of impaired renal function. Colchicine is to be used with caution in patients with impaired renal function especially in those who are concomitantly administering other drugs that may further inhibit colchicine clearance.