Cerivastatin is novel HMG-CoA reductase inhibitors. Clinical trials showed no significant differences of serum creatine kiase between cerivastatin and placebo, and cerivastatin-induced myopathy was rarely reported. This beneficial effect of cerivastatin is thought to be related to the the dual pathway metabolism by hapatic CYP3A4 and 2C8. We here report three cases of rhabdomyolysis which is associated with cerivastatin therapy. Two patients had diabetes mellitus, and received cerivastatin(0.8 mg/day) for treating hyperlipidemia and the other patient had chronic renal failure due to diabetic nephropathy and has maintained peritoneal dialysis and received cerivastatin(0.4 mg/day). Within one month of cerivastatin treatment, those patients experienced myalgia or muscle weakness. At that time, laboratory findings including muscle enzyme level, and bone scan finding were compatible with rhadomyolysis. Under the impression of cerivastatin- induced rhabodmyolysis, cerivastatin was withdrwan, and conventional treatment for rhabdomyolysis was started. Clinical course was uneventful, and these patients were discharged with good general condition. In conclusion, cerivastatin is regarded as a safe drug as compared with other statins, but it also causes rhabdomyolysis. Careful history taking and regular follow-up of muscle enzyme levels would be necessary to detect cerivastatin-induced rhabdomyolysis.
Creatine ; Diabetes Mellitus ; Diabetic Nephropathies ; Follow-Up Studies ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors ; Hyperlipidemias ; Kidney Failure, Chronic ; Metabolism ; Muscle Weakness ; Muscular Diseases ; Myalgia ; Peritoneal Dialysis ; Rhabdomyolysis*

Autosomal dominant polycystic kidney disease(ADPKD) is one of the most common hereditary diseases, and frequently has well defined extrarenal manifestations. Among the fatal vascular complications associated with ADPKD, ruptured intracerebral aneurysm and ruptured abdominal aortic aneurysm are widely known. Intramural hematoma(IMH) is a rare but potentially disastrous complication, and clinicians should always consider this when dealing with patients with ADPKD who present with acute dyspnea or chest pain. We report a case of a 67-year-old woman with the IMH as a fatal complication of ADPKD and intracranial aneurysm.
Aged ; Aneurysm ; Aortic Aneurysm, Abdominal ; Chest Pain ; Dyspnea ; Female ; Genetic Diseases, Inborn ; Hematoma* ; Humans ; Intracranial Aneurysm* ; Polycystic Kidney Diseases ; Polycystic Kidney, Autosomal Dominant*