Prasad G V Ramesh, Wong Timothy, Meliton Galo, Bhaloo Salma
Division of Nephrology, Department of Medicine, St. Michael's Hospital, University of Toronto, 61 Queen Street East, 9th Floor, Toronto, Ontario M5C 2T2 Canada.
Transplantation. 2002 Oct 27;74(8):1200-1. doi: 10.1097/00007890-200210270-00028.
Rhabdomyolysis is a known complication of hepatic 3-methylglutaryl coenzyme A reductase (HMG-CoA) inhibitor (statin) therapy for posttransplant hyperlipidemia, and thus monitoring for this effect is indicated. We report a case of an herbal preparation-induced rhabdomyolysis in a stable renal-transplant recipient, attributed to the presence of red yeast rice (Monascus purpureus) within the mixture. The condition resolved when consumption of the product ceased. Rice fermented with red yeast contains several types of mevinic acids, including monacolin K, which is identical to lovastatin. We postulate that the interaction of cyclosporine and these compounds through the cytochrome P450 system resulted in the adverse effect seen in this patient. Transplant recipients must be cautioned against using herbal preparations to lower their lipid levels to prevent such complications from occurring.
横纹肌溶解症是肝移植后高脂血症采用3-甲基戊二酰辅酶A还原酶（HMG-CoA）抑制剂（他汀类药物）治疗时已知的并发症，因此需要监测这种效应。我们报告了1例稳定期肾移植受者因草药制剂导致横纹肌溶解症的病例，该病例归因于该混合物中存在红曲米（紫红曲霉）。停用该产品后病情缓解。用红曲发酵的米含有多种美伐他汀酸，包括与洛伐他汀相同的莫纳可林K。我们推测环孢素与这些化合物通过细胞色素P450系统相互作用导致了该患者出现不良反应。必须告诫移植受者不要使用草药制剂来降低血脂水平，以防止发生此类并发症。
