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Fenofibrate monotherapy-induced rhabdomyolysis in a patient with hypothyroidism: A rare case report and literature review
Open accessAbstract
RATIONALE: Fenofibrate is a fibric acid derivative indicated for use in hypertriglyceridemia and mixed dyslipidemia treatment among adults. Rhabdomyolysis is a syndrome characterized by muscle necrosis and the release of intracellular muscle contents into the systemic circulation, which is the most serious and fatal side effect of fenofibrate. The objective of this paper is to discuss fatal side effect of fenofibrate and keep safe medication. PATIENT CONCERNS: A patient with hypothyroidism who presented with rhabdomyolysis during fenofibrate monotherapy for hypertriglyceridemia was reported. DIAGNOSES: Fenofibrate Monotherapy Induced Rhabdomyolysis. INTERVENTIONS: Fenofibrate was stopped. Adequate fluid resuscitation, mannitol diuresis, myocardium protection, hepatoprotection and urine alkalinization with sodium bicarbonate were performed. OUTCOMES: Blood tests were normal and the patient was good and discharged 2 weeks later. LESSONS: 13 cases associated with fenofibrate monotherapy-induced rhabdomyolysis were reviewed, which had been published in the English literature. The severity of fenofibrate muscle toxicity may be the result of the combination of two rhabdomyolysis enhancers, such as hypothyroidism and female gender. To avoid it, strict clinical and laboratory monitoring should be maintained, particularly hypothyroidism. Patients should be informed of possible potentially irreversible effects after taking fibrates.
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Cites
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Vanweert, F., Schrauwen, P., & Phielix, E. (2022) · Nutrition and Diabetes · doi:10.1038/s41387-022-00213-3 · Cited by 332
Safitri, N., Alaina, M. F., Pitaloka, D. A. E., & Abdulah, R. (2021) · Drug Healthcare and Patient Safety · doi:10.2147/dhps.s333738 · Cited by 64
The role of peroxisome proliferator-activated receptors in healthy and diseased eyes
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Peroxisome proliferator-activated receptor α as a novel therapeutic target for schizophrenia
Wada, Y., Maekawa, M., Ohnishi, T., Balan, S., Matsuoka, S., Iwamoto, K., Iwayama, Y., Ohba, H., Watanabe, A., Hisano, Y., et al. (2020) · EBioMedicine · doi:10.1016/j.ebiom.2020.103130 · Cited by 39
Balakumar, P., Ramanathan, S., Mahadevan, N., Muhsinah, A. B., Alsayari, A., Venkateswaramurthy, N., & Dhanaraj, S. A. (2019) · Pharmacological Research · doi:10.1016/j.phrs.2019.03.025 · Cited by 32
Metadata
- Authors
- Wang, D., & Wang, Y.
- Affiliations
- The Second Affiliated Hospital of Bengbu Medical College (CN)
- Corresponding author
- Wang, Dawei
- Venue
- Medicine
- Published
- 2018-04
- Volume
- 97
- Issue
- 14
- Pages
- e0318
- ISSN
- 0025-7974 (ISSN-L)
- PMC
- PMC5902300
- OpenAlex
- W2796064503
- Cited by
- 22
- References
- 20
- Citations by year
- 2026: 2 · 2025: 1 · 2024: 3 · 2023: 1 · 2022: 1 · 2021: 3 · 2020: 5 · 2019: 4 · 2018: 2
- FWCI
- 3.64
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by-nc
- Locations
- Medicine (publishedVersion, cc-by-nc)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- Funders
- Bengbu Medical College
- Bengbu University
- Topics
- Health Sciences › Medicine › Surgery › Muscle and Compartmental Disorders
- Health Sciences › Medicine › Hematology › Methemoglobinemia and Tumor Lysis Syndrome
- Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Pharmacology › Drug-Induced Hepatotoxicity and Protection
- Keywords
- fenofibrate, rhabdomyolysis, hypothyroidism, hypertriglyceridemia, fibrates, adverse drug reactions, drug safety, female sex as risk factor, mannitol diuresis, fluid resuscitation, hepatoprotection, urinary alkalinization
- MeSH terms
- Adult, Hypolipidemic Agents, Female, Humans, Hypothyroidism, Fenofibrate, Rhabdomyolysis, Hypertriglyceridemia
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