Iatrogenia a importância do diagnóstico clínico miopatia induzida por clofibrate

Godoy, J. M.; Nicaretta, Denise H.; Balassiano, S. L.; Skacel, M.

doi:10.1590/S0004-282X1992000100022

Resumos

Os autores descrevem o caso de uma enferma que apresentou síndrome polimio-site símile durante tratamento de hipercolesterolemia com clofibrate. Com ia suspensão da medicação, os sinais e sintomas de acometimento muscular desapareceram por completo. Os autores chamam a atenção para a importância das miopatias iatrogênicas no diagnóstico diferencial de pacientes com doenças do sistema neuromuscular.

iatrogenia; miopatia; clofibrate

The authors describe the neurological manifestations of a female patient with hypercholesterolemia who developed myopathy in the course of her treatment with clofibrate. After the drug was tapered off, the neurological signs and symptoms disappeared. Therefore, attention is called for the importance of the differential diagnosis of iatrogenic myopathies with polymyositis.

iatrogeny; myopathy; clofibrate

J. M. Godoy^I; Denise H. Nicaretta^II; S. L. Balassiano^III; M. Skacel^IV

^IProfessor Adjunto de Neurologia, Universidade do Estado do Rio de Janeiro (UERJ)

^IIPó-graduanda em Neurologia, UERJ

^IIIProfessor Assistente de Neuroloiga, UERJ

^IVProfessor Auxiliar de Neurologia, UERJ

RESUMO

Os autores descrevem o caso de uma enferma que apresentou síndrome polimio-site símile durante tratamento de hipercolesterolemia com clofibrate. Com ia suspensão da medicação, os sinais e sintomas de acometimento muscular desapareceram por completo. Os autores chamam a atenção para a importância das miopatias iatrogênicas no diagnóstico diferencial de pacientes com doenças do sistema neuromuscular.

Palavras chave: iatrogenia, miopatia, clofibrate.

SUMMARY

The authors describe the neurological manifestations of a female patient with hypercholesterolemia who developed myopathy in the course of her treatment with clofibrate. After the drug was tapered off, the neurological signs and symptoms disappeared. Therefore, attention is called for the importance of the differential diagnosis of iatrogenic myopathies with polymyositis.

Key words: iatrogeny, myopathy, clofibrate.

Texto completo disponível apenas em PDF.

Full text available only in PDF format.

Dr. José Maurício Godoy Rua Ozório Duque Estrada 74/902 B - 22451 Rio de Janeiro RJ -Brasil

1. Argov Z, Mastaglia FL. Drug-induced neuromuscular disorders in man. In Walton J (ed) : Disorders of Voluntary Muscle. Edinburgh: Churchill Livingstone, 1988, p 981-1014.
2. Bridgman JF, Rosen SM, Thorp JM. Complications during clofibrate treatment of nephrotic-syndrome hyperlipoproteinemia. Lancet 1972, 2:506-509.
3. Gabriel R, Pearce JMS. Clofibrate-induced myopathy and neuropathy. Lancet 1976, 2:906.
4. Geltner D, Shapiro M, Chaco M. Reversible myopathy induced by clofibrate. Postgrad Med J 1975, 51:184-185.
5. Kingston WJ, Moxley RT. Inflamatory myopathies. Neurol Clin 1988, 545-561.
6. Kuncl RW, Wiggins WW. Toxic myopathies. Neurol Clin 1988, 6:593-619.
7. Langer T, Levy RI. Acute muscular syndrome associated with administration of clofibrate. N Engl J Med 1968, 279:856-898.
8. Paul HS, Adibi SA. Paradoxical effects of clofibrate on liver and muscle metabolism in rats. J Clin Invest 1979, 64:405-412.
9. Pierides AM, Alvarez-Ude F, Kerr DNS, Skillen AW. Clofibrate-induced muscle damage in patients with chronic renal failure. Lancet 1975, 2:1279.
10. Rumpf KW, Albers R, Scheler F. Clofibrate-induced myopathy syndrome. Lancet 1976, 1:249-250.
11. Rush P, Baron M, Kapusta M. Clofibnate myopathy: a case report and a review of the literature. Semin Arthritis Rheum 1986, 15:226-229.
12. Sekowski I, Samuel P. Clofibrate-induced acute muscular syndrome, Am J Cardiol 1972, 30:572-574.
13. Smals AGH, Beex LVAM, Kloppenborg PWC. Clofibrate-induced muscle damage with myoglobinuria and cardiomyopathy. N Engl J Med 1977, 296:942.
14. Smith AF, Macfie WG, Oliver MF. Clofibrate, serum enzymes and muscle pain. Br Med J 1970, 2:86-88.
15. Vester JW, Sabeh G, Danoswki TS. No muscle damage from clofibrate. N Engl J Med 1969, 280:110-111.

Iatrogenia a importância do diagnóstico clínico miopatia induzida por clofibrate

Iatrogeny: the importance of clinical diagnosis. Clofibrate induced myopathy

Datas de Publicação

Publicação nesta coleção
22 Fev 2011
Data do Fascículo
Mar 1992

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

[1] 1. Argov Z, Mastaglia FL. Drug-induced neuromuscular disorders in man. In Walton J (ed) : Disorders of Voluntary Muscle. Edinburgh: Churchill Livingstone, 1988, p 981-1014.

[2] 2. Bridgman JF, Rosen SM, Thorp JM. Complications during clofibrate treatment of nephrotic-syndrome hyperlipoproteinemia. Lancet 1972, 2:506-509.

[3] 3. Gabriel R, Pearce JMS. Clofibrate-induced myopathy and neuropathy. Lancet 1976, 2:906.

[4] 4. Geltner D, Shapiro M, Chaco M. Reversible myopathy induced by clofibrate. Postgrad Med J 1975, 51:184-185.

[5] 5. Kingston WJ, Moxley RT. Inflamatory myopathies. Neurol Clin 1988, 545-561.

[6] 6. Kuncl RW, Wiggins WW. Toxic myopathies. Neurol Clin 1988, 6:593-619.

[7] 7. Langer T, Levy RI. Acute muscular syndrome associated with administration of clofibrate. N Engl J Med 1968, 279:856-898.

[8] 8. Paul HS, Adibi SA. Paradoxical effects of clofibrate on liver and muscle metabolism in rats. J Clin Invest 1979, 64:405-412.

[9] 9. Pierides AM, Alvarez-Ude F, Kerr DNS, Skillen AW. Clofibrate-induced muscle damage in patients with chronic renal failure. Lancet 1975, 2:1279.

[10] 10. Rumpf KW, Albers R, Scheler F. Clofibrate-induced myopathy syndrome. Lancet 1976, 1:249-250.

[11] 11. Rush P, Baron M, Kapusta M. Clofibnate myopathy: a case report and a review of the literature. Semin Arthritis Rheum 1986, 15:226-229.

[12] 12. Sekowski I, Samuel P. Clofibrate-induced acute muscular syndrome, Am J Cardiol 1972, 30:572-574.

[13] 13. Smals AGH, Beex LVAM, Kloppenborg PWC. Clofibrate-induced muscle damage with myoglobinuria and cardiomyopathy. N Engl J Med 1977, 296:942.

[14] 14. Smith AF, Macfie WG, Oliver MF. Clofibrate, serum enzymes and muscle pain. Br Med J 1970, 2:86-88.

[15] 15. Vester JW, Sabeh G, Danoswki TS. No muscle damage from clofibrate. N Engl J Med 1969, 280:110-111.