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Severe rhabdomyolysis due to rosuvastatin in a liver transplant subject with human immunodeficiency virus and immunosuppressive therapy–related dyslipidemia

✍ Scribed by Ana Moreno; Jesús Fortún; Javier Graus; Miguel A. Rodriguez-Gandía; Carmen Quereda; María J. Pérez-Elías; Javier Nuño; Philip Wikman; Santiago Moreno; Rafael Bárcena


Publisher
John Wiley and Sons
Year
2011
Tongue
English
Weight
70 KB
Volume
17
Category
Article
ISSN
1527-6465

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✦ Synopsis


Statins are relatively safe first-line agents to use in the setting of dyslipidemia associated with immunosuppressive therapy in subjects undergoing liver transplantation, and also in HIV-infected patients with dyslipidemia due to antiretroviral drugs, especially ritonavir-boosted protease inhibitors. Rosuvastatin, a new statin, has demonstrated higher potency than previously released statins and is not extensively metabolized by the liver P450 system; therefore, the probability of deleterious pharmacokinetic interactions with commonly used immunosuppressants and antiretroviral drugs is reduced. We present the first case of severe rhabdomyolysis in a liver transplant patient receiving rosuvastatin for the treatment of immunosuppressive therapy-related grade IV dyslipidemia, an HIV-infected subject on protease inhibitor-sparing HAART, that resolved after rosuvastatin withdrawal, probably related to interactions between calcineurin inhibitors and hepatic rosuvastatin uptake transporters such as Organic Anion Transporting Polypeptides (OATPs).