Colchicine-induced myopathy in a teenager with familial editerranean fever

OBJECTIVE: To report a case of colchicine-induced myopathy in a teenager with familial Mediterranean fever (FMF)

The evaluation of coagulation parameters and vessel involvement in Behcet' s disease. A clinical experience of Behcet' s disease: Study of 152 cases

PubMed ID: 23690099Behcet's disease (BD) is accepted as a systemic vasculitis. Vasculitis is observed predominantly on the venous system. Vessel involvement is frequently seen in males. This study was planned retrospectively evaluate demographic features, clinical features, vessel involvements in BD. Furthermore, we aimed to prospectively compare consecutively chosen patients with and without thrombosis and healthy volunteers in terms of their biochemical, immunological, coagulation parameters. One hundred fifty-two Behcet´s patients were retrospectively evaluated. Blood samples were collected from 52 consecutively chosen patients and 41 healthy subjects. Papulopustular skin lesions, eye involvement and venous lesions were detected frequent in males. In terms of evaluated parameters (biochemical parameters, coagulation parameters, C-reactive protein, erythrocyte sedimentation rate, anticardiolipin antibodies, antinuclear antibody positivity) was not found a significant difference among groups (patients without thrombosis, healthy control subjects, patients with thrombosis). We detected statistically significant difference in terms of factor V levels between patient and control group. The tendency to thrombosis in patients with BD is well known. The endothelial lesion, increased procoagulant activity, hypofibrinolysis were found to be responsible from these events. In our study, there was no significant difference in terms of coagulation parameters between the patients without and with thrombosis. © 2013 Tehran University of Medical Sciences. All rights reserved

Rhabdomyolysis associated with gemfibrozil-colchicine therapy

OBJECTIVE: To report a case of rhabdomyolysis possibly due to combination therapy with colchicine and gemfibrozil. CASE SUMMARY: A 40-year-old man with amyloidosis and hepatitis B virus-related chronic liver disease was admitted to the university hospital because of fatigue, lack of appetite, dark brownish urine, and myalgia for 2 weeks. The patient was receiving colchicine and gemfibrozil. Elevations of serum creatine kinase, lactate dehydrogenase, and aspartate aminotransferase concentrations with myalgia were compatible with the diagnosis of rhabdomyolysis. DISCUSSION: To our knowledge, myopathy and rhabdomyolysis due to a combination of colchicine and gemfibrozil therapy have not been previously reported. Preexisting mild renal failure, hepatitis B-related chronic liver disease, and amyloidosis may be contributing risk factors for the development of rhabdomyolysis in this patient. An objective causality assessment revealed that the adverse drug event was possible. CONCLUSIONS: Patients receiving combination therapy with colchicine and gemfibrozil, especially those with renal and hepatic dysfunction, should be monitored for rhabdomyolysis, and concomitant colchicine and gemfibrozil therapy should be considered in the differential diagnosis of rhabdomyolysis

Hyperkalemia occurring in a patient with psoriatic arthritis following indomethacin use

Objective: To report a case of hyperkalemia possibly due to indomethacin use. Case Summary: A 52-year-old white woman with psoriatic arthritis for 16 years and diabetes mellitus for 3 years was admitted to the university hospital due to swelling and pain of wrists, elbows, knees and ankles for the last one month. The patient had been receiving methotrexate irregularly, but discontinued it 3 months ago. Physical examination and laboratory evaluations were compatible with diagnosis of exacerbation of psoriatic arthritis and type 2 diabetes mellitus. Two days after initiation of indomethacin and methotrexate, hyperkalemia developed with increase of blood urea nitrogen and decrease of creatinine clearance. Indomethacin was discontinued, and this resulted in normalization of laboratory findings between day 5 and 10 after discontinuation. Conclusion: The development of hyperkalemia caused by indomethacin is probably unusual, but it is important because indomethacin is a commonly used medication. This potentially serious complication can be prevented by careful attention to renal function and potassium balance in patients receiving indomethacin and other nonsteroidal anti-inflammatory drugs (NSAIDs), especially in patients with type 2 diabetes mellitus or preexisting renal disease

[Evaluation of frequency and the attacks features of patients with colchicine resistance in FMF].

INTRODUCTION: Colchicine is the mainstay for the treatment of FMF, which is an auto-inflammatory disease mainly with relapsing polyserositis. Despite daily doses of 2mg or more each day, approximately 5% to 10% of the patients continue to suffer from its attacks. In this study, we aimed to investigate the depression and attack features in patients with FMF who have colchicine resistance (CR). PATIENTS E METHODS: CR was defined for FMF patients with 2 or more attacks within the last 6 months period while using 2mg/day colchicine. Eighteen patients (9 Female/9 Male) were enrolled into the CR group and 41 patients were enrolled into the control group (12 Male/29 Female). Demographic, clinical e laboratory findings, treatment adherence, and the Beck Depression Inventory (BDI) scores were evaluated. RESULTS: The age of onset of FMF was significantly lower in the CR group (12.3 yrs vs. 16.9 yrs, P=0.03). Disease duration was longer in the CR group (P=0.01). Abdominal and leg pain due to exercise were significantly more frequent in the CR group versus controls (83% vs. 51%; P=0.02 e 88% vs. 60%; P=0.04, respectively). Patients with BDI scores over 17 points were more frequent in the CR group compared to controls (50% vs. 34.1%; P<0.001). DISCUSSION: We found that: (1) the age of disease onset was lower and (2) the disease duration was longer in CR group. Pleuritic attacks, hematuria e proteinuria were more frequent in CR patients. We propose that depression is an important factor to consider in the susceptibility to CR