One case of rhabdomyolysis caused by fenofibrate in a patient with hypothyroidism

A 37-year-old man was given oral fenofibrate sustained release capsules 250 mg every night for the treatment of hyperlipidemia.Before the treatment,laboratory examinations showed the following values:TG 17.17 mmol·L-1,CK 45 U·L-1,LDH 98 U·L-1,AST 30 IU·L-1,ALT 21 IU·L-1.After 9 days of the treatment,he developed the right cruris muscular soreness and hypodynamia.The laboratory examinations revealed:CK 2900.05 U·L-1,LDH 432 U·L-1,AST 121 IU·L-1,ALT 65.5 IU·L-1.He was diagnosed with rhabdomyolysis.Fenofibrate was stopped immediately.The patient was treated with urine alkalinization and protection of cell membrane.The thyroid gland function test showed:TT3 0.3 nmol·L-1,TT4 7.5 nmol·L-1,FT3 1.9 pmol·L-1,FT4 7.8 pmol·L-1 and TSH 237 μIU·mL-1.Diffuse thyroid disease was found by the ultrasound of thyroid gland.He was diagnosed with hypothyroidism and given oral levothyroxine tablets.Three days later,his symptom disappeared.Twenty-seven days later,the level of creatinine phosphokinases and transaminases nearly returned to normal.