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Neurology 2003;60:124-126
© 2003 American Academy of Neurology
Brief Communications

Myoglobinuria and COX deficiency in a patient taking cerivastatin and gemfibrozil

J. Arenas, PhD, M.A. Fernández-Moreno, PhD, J.A. Molina, MD, V. Fernández, MD, P. del Hoyo, PharmB, Y. Campos, MSc, P. Calvo, MD, M.A. Martín, PhD, A. García, MSc, T. Moreno, MD, A. Martínez-Salio, MD, B. Börnstein, MD, F. Bermejo, MD, A. Cabello, MD and R. Garesse, PhD

From the Centro de Investigación (Drs. Arenas and Martín, and P. del Hoyo, Y. Campos, and A. García), Servicio de Neurología (Drs. V. Fernández, Molina, Calvo, Moreno, Martínez-Salio, and Bermejo), and Servicio de Anatomía Patológica (Dr. Cabello), Hospital Universitario 12 de Octubre; and Instituto Investigaciones Biomédicas "Alberto Sols" UAM-CSIC (Drs. Fernández-Moreno, Börnstein, and Garesse), Madrid, Spain.

Address correspondence and reprint requests to Dr. Joaquín Arenas, Centro de Investigación, Hospital Universitario 12 de Octubre, Avda Córdoba km 5.4, 28041 Madrid, Spain; e-mail: jarenas{at}h12o.es

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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