Myoglobinuria and COX deficiency in a patient taking cerivastatin and gemfibrozil.

Arenas, J; Fernández-Moreno, M A; Molina, J A; Fernández, V; del Hoyo, P; Campos, Y; Calvo, P; Martín, M A et al. · Neurology · 2003

case_report · Level V

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Abstract

The authors describe a patient who presented with myoglobinuria after starting cerivastatin-gemfibrozil therapy. Muscle histochemistry revealed ragged-red fibers and cytochrome c oxidase negative (COX) fibers, and biochemistry showed a defect of COX activity. Immunoblot analysis showed a 60% reduction of COX I and COX II polypeptides. Cerivastatin myotoxicity might be related to a depletion of essential metabolites needed to anchor COX subunit I to mitochondrial membrane.

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