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Case Report
Accepted: February 6, 2002
Key Words
Colchicine - Myopathy - Renal transplantation
Abstract
A case of a renal transplant recipient with colchicine-- induced myopathy is presented. He was on colchicine therapy for 10 months. He was hospitalized for investigation of fatigue, severe myalgia in the lower extremities and elevated serum aminotransferase levels. His viral markers and other factors that may cause myalgia and that may increase the serum aminotransferase levels were either normal or negative. Creatine phosphokinase (CK) levels were normal. Electrophysiological findings indicated myopathy and muscle biopsy was consistent with vacuolar myopathy. After withdrawal of colchicine, the symptoms disappeared gradually and serum aminotransferase levels were normalized. We suggest that colchicine myopathy should be taken into account in patients who have been on colchicine therapy and had unexplained myalgia as well as elevated aminotransferase levels even with normal CK levels.
Introduction
Drug-induced myopathy is an important cause of muscle disease. Its precise incidence is not known. Myopathy has been reported as an important side effect of colchicine administration especially in patients with renal failure [1]. It is generally believed that colchicine-induced myopathy is associated with rather high creatine phosphokinase (CK) levels. The present report describes a renal transplant recipient with normal serum creatinine and CK levels who developed colchicine-induced myopathy.
Case Report
A 47-year-old man was admitted to the hospital in June 1999, because of weakness, fatigue and diffuse muscle pain in the distal extremities. He received a cadaveric kidney allograft in 1996 for end-- stage renal failure due to amyloidosis secondary to familial Mediterranean fever (FMF). Prior to the kidney transplantation he had undergone hemodialysis for 14 months. The patient was in good health until 1 week before admission. The immunosuppressive regimen consisted of cyclosporine (200 mg daily), azathioprine (100 mg daily) and prednisolone (10 mg daily). Colchicine (0.6 mg b.i.d.) has been given since September 1998 when he developed an FMF attack.
On admission, his blood pressure was 120/70 mm Hg, pulse rate was 70 bpm and respiratory...