Hypothyroidism rhabdomyolysis

Rhabdomyolysis is the destruction of skeletal muscle tissues and may be associated with lipid-regulating drugs such as the fibrates and the statins. The risk of this side-effect is increased in patients with renal impairment and with hypothyroidism. Rhabdomyolysis may also occur with nicotinic acid, the antipsychotic aripiprazole, and the anaesthetic propofol. 

Hong, J.-J., Lin, J.-L., Wu, M.-S., Huang, C.-C. Verberckmoes, R. (1996) A chronic glue sniffer with hyperchloraemia metabolic acidosis, rhabdomyolysis, irreversible quadriplegia, central pontine myelinolysis, and hypothyroidism. Nephrol. Dial. Transpl., 11, 1848-1849... 

Hypothyroidism predisposes to rhabdomyolysis (53,54) and screening of thyroid function has been advocated before starting hypolipidemic drugs (SEDA-21, 458). This notion has been supported by observations in a 69-year-old man taking fenofibrate 200 mg daily (55). The muscular syndrome appears to be a special risk in patients with nephrotic syndrome (SEDA-13,1325 56). 

Two women, 55 and 57 years old, with renal insufficiency, had rhabdomyolysis after taking micronized fenofibrate in dosages a little higher than recommended (57). Both had mild hypothyroidism. 

Clouatre Y, Leblanc M, Ouimet D, Pichette V. Fenofibrate-induced rhabdomyolysis in two dialysis patients with hypothyroidism. Nephrol Dial Transplant 1999 14(4) 1047-8. 

Hypothyroidism predisposes to rhabdomyolysis and screening thyroid function has been advocated before starting hypolipidemic drugs (SEDA-21, 458). 

The Committee on Safety of Medicines (CSM) has advised that rhabdomyolysis with lipid-regulating drugs is rare (1 case in every 100 000 treatment years) but may be increased in those with renal impairment and/or hypothyroidism. 

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