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Partial Muscle Carnitine Palmitoyltransferase-A DeficiencyRhabdomyolysis Associated With Transiently Decreased Muscle Carnitine Content After Ibuprofen Therapy
Nathan S. Ross, MD;
Charles L. Hoppel, MD
JAMA. 1987;257(1):62-65.
Abstract
After initiation of ibuprofen therapy, a 45-year-old woman developed muscle weakness and tenderness with rhabdomyolysis, culminating in respiratory failure. A muscle biopsy specimen showed a vacuolar myopathy, and markedly decreased muscle carnitine content and carnitine palmitoyltransferase activity. Following recovery, muscle carnitine content was normal but carnitine palmitoyltransferase activity was still abnormally low. The ratio of palmitoyl— coenzyme A plus carnitine to palmitoylcarnitine oxidation by muscle mitochondria isolated from the patient was markedly decreased. We conclude that transiently decreased muscle carnitine content interacted with partial deficiency of carnitine palmitoyltransferase-A to produce rhabdomyolysis and respiratory failure and that ibuprofen may have precipitated the clinical event.
(JAMA 1987:257:62-65)
Author Affiliations
From the University Hospitals of Cleveland, the Cleveland Veterans Administration Medical Center, and the Departments of Medicine (Drs Ross and Hoppel) and Pharmacology (Dr Hoppel), Case Western Reserve University School of Medicine, Cleveland.
Footnotes
Reprint requests to Veterans Administration Medical Center (151W), 10701 East Blvd, Cleveland, OH 44106 (Dr Hoppel).
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