Clinical Study and Literature Analysis of Rhabdomyolysis in Hypothyroidism Caused by Fenofibrate / 中国药学杂志

ABSTRACT

OBJECTIVE: To explore clinical characteristics of rhabdomyolysis caused by fenofibrate in patients with hypothyroidism. METHODS: A clinical case was analyzed and summarized the literature of adverse reactions of rhabdomyolysis caused by fenofibrate in patients with hypothyroidism reported in China and abroad. RESULTS: A 25-year-old female with hyperlipidemia combined with hypothyroidism developed rhabdomyolysis at 12th day after taking fenofibrate. Before the occurrence of rhabdomyolysis, highlevelof TSH was detected. After occurrence of adverse reactions, the patient stopped taking fenofibrate, rehydrated and alkalized urine. Then the patient recovered and discharged. In the literature review, 11 cases of rhabdomyolysis with fenofibrate in hypothyroidism were included. The age range was 25-68. The sex ratio was 1∶2. On thyroid function, there were 3 cases unknown, 6 cases with hypothyroidism and 2 cases with FT4 at the lowest normal limit. On doses of fenofibrate, there were 9 cases under the instructions, and 3 cases beyond the recommendations in labeling. Most adverse drug reactions (ADRs) occurred at the third to 60th day after taking fenofibrate. Ten patients recovered and 2 patients improved. CONCLUSION: Hypothyroidism would be a risk factor for rhabdomyolysis caused by fenofibrate. Thyroid function should be monitored in patients taking fenofibrate with hypothyroidism.