The case is presented a 49-year-old man had several year history with chronic renal failure with hyperlipidemia due to diabetes mellitus. Treatment of hyperlipidemia was started by oral bezafibrate intake 600 mg per day. Several days later, patient noticed muscle weakness and myalgia. The serum CK, LDH, AST levels were remarkably elevated, myoglobulinuria was also noticed The symptoms of the patient were resolved after the drug was discontinued, thus the diagnosis was established as having bezafibrate induced rhabdomyolysis. On the basis of the above description, bezafibrate may induce muscle damage if dose is excess over the renal capacity. Extreme caution is warranted when the patient is placed on bezafibrate and has renal dysfunction.Strict dose adjustment is necessary in taking account of renal function to avoid muscle damage including rhabdomyolysis.
Bezafibrate ; Diabetes Mellitus ; Diagnosis ; Humans ; Hyperlipidemias ; Kidney Failure, Chronic ; Middle Aged ; Muscle Weakness ; Myalgia ; Rhabdomyolysis

Castleman's disease is a rare disorder of unknown etiology that results in the unregulated growth of lymphoid tissue. It can be classified as unicentric and multicentric based on clinical and radiological findings, and also as hyaline vascular and plasma cell type based on histopathology. Castleman's disease may present as an asymptomatic involvement of one lymph node group or as a multicentric disease with systemic features. However, renal involvement is very rare. Here we report a 50-year old male patient with histopathologically proven multicentric plasma cell type of Castleman's disease who presented with weight loss, palpable cervical lymphadenopathy, azotemia and proteinuria. The finding of a percutaneous needle renal biopsy was compatible with plasma cell type of Castleman's disease. After treated with systemic corticosteroid, azotemia and proteinuria disappeared.
Azotemia ; Biopsy ; Giant Lymph Node Hyperplasia* ; Humans ; Hyalin ; Kidney* ; Lymph Nodes ; Lymphatic Diseases ; Lymphoid Tissue ; Male ; Middle Aged ; Needles ; Plasma Cells ; Proteinuria ; Weight Loss

PURPOSE: To clarify the clinical benefit derived from the combined modality therapy (CMT) consisting of chemotherapy (CT) and involved field radiotherapy (RT) for stage I and II angiocentric lymphomas of the head and neck. MATERIALS AND METHODS: Of 143 patients with angiocentric lymphoma of the head and neck treated at our hospital between 1976 and 1995, 104 patients (RT group) received involved field RT alone with a median dose of 50.4 Gy (range : 20-70 Gy), while 39 patients (CMT group) received a median 3 cycles (range : 1-6 cycles) of CT before involved field RT. The response rate, patterns of failure, complications, and survival data of the RT group were compared with those of the CMT group. RESULTS: Despite a higher response rate, local failure was the most common pattern of failure in patients of both groups. The patterns of failure, including the systemic relapse rate were not influenced by the addition of combination CT. Although both modalities were well tolerated by the majority of patients, aberrant immunologic disorders or medical illnesses, such as a hemophagocytic syndrome, sepsis, intractable hemorrhage, or the evolution of second primary malignancies were more frequently observed in patients of the CMT group. The prognosis of patients in the RT group was relatively poor, with a 5-year overall actuarial survival rate of 38% and disease-free survival rate of 32%, respectively. However, their clinical outcome was not altered by the addition of systemic CT. Achieving complete remission was the most important prognostic factor by univariate and multivariate analyses, but treatment modality was not found to be a prognostic variable influencing survival. Conclusions : Involved field RT alone for angiocentric lymphoma of the head and neck was insufficient to achieve an improved survival rate, but the addition of CT to involved field RT failed to demonstrate any therapeutic advantage over involved field RT alone.
Combined Modality Therapy ; Disease-Free Survival ; Drug Therapy* ; Head* ; Hemorrhage ; Humans ; Lymphohistiocytosis, Hemophagocytic ; Lymphoma* ; Multivariate Analysis ; Neck* ; Prognosis ; Radiotherapy* ; Recurrence ; Sepsis ; Survival Rate