Wang YH, Zhang SS, Li HT, Zhi HW, Wu HY. Rhabdomyolysis-induced acute kidney injury after administration of a red yeast rice supplement: A case report. World J Clin Cases 2023; 11(23): 5547-5553 [PMID: 37637685 DOI: 10.12998/wjcc.v11.i23.5547]
Corresponding Author of This Article
Hong-Yun Wu, PhD, Director, Department of Neurology, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, No. 16369 Jingshi Road, Jinan 250014, Shandong Province, China. whylzhangonly@126.com
Research Domain of This Article
Medical Informatics
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Ya-Han Wang, Si-Shuo Zhang, Hai-Tao Li, Hong-Wei Zhi, Hong-Yun Wu, Department of Neurology, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan 250014, Shandong Province, China
Author contributions: Wang YH was responsible for writing the manuscript; Zhang SS was responsible for language editing; Li HT and Zhi HW were responsible for data collection; Wu HY were responsible for the diagnosis and differential diagnosis; all authors have read and approved the final manuscript.
Supported bythe Natural Science Foundation of Shandong Province, No. ZR2021QH110.
Informed consent statement: Informed written consent was obtained from the patient for the publication of this case report.
Conflict-of-interest statement: The authors that they have no conflict of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Hong-Yun Wu, PhD, Director, Department of Neurology, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, No. 16369 Jingshi Road, Jinan 250014, Shandong Province, China. whylzhangonly@126.com
Received: April 22, 2023 Peer-review started: April 22, 2023 First decision: June 12, 2023 Revised: June 17, 2023 Accepted: July 17, 2023 Article in press: July 17, 2023 Published online: August 16, 2023 Processing time: 116 Days and 1.7 Hours
Abstract
BACKGROUND
A few reports have revealed induction of rhabdomyolysis by a red yeast rice (RYR) supplement or by RYR in combination with abiraterone (an androgen biosynthesis inhibitor).
CASE SUMMARY
A 76-year-old man presented with progressive limb weakness, muscle soreness, and acute kidney injury (AKI). He had been taking the anti-prostate cancer drug abiraterone for 14 mo and had added a RYR supplement 3 mo before symptom onset. After being diagnosed with rhabdomyolysis-induced AKI, the patient discontinued these drugs and responded well to hemodialysis and hemoperfusion. After 23 d of treatment, creatine kinase levels returned to normal and serum creatinine levels decreased.
CONCLUSION
We speculate that statins, the main lipid-lowering component of RYR, or a combination of statins and abiraterone, will increase the risk of rhabdomyolysis.
Core Tip: In September 2021, a 76-year-old man presented with muscle soreness, limb weakness, and impaired kidney function. He had been taking the anti-prostate cancer drug abiraterone for 14 mo and had added a red yeast rice (RYR) supplement 3 mo before symptom onset. The patient was asked to stop taking these two drugs. He then underwent hemodialysis and hemoperfusion therapy. We measured renal function and muscle damage indicators continuously for 23 d until they returned to normal. The statin content of RYR supplements should be kept in mind, as well as the increased risk of muscle and kidney damage when combined with abiraterone.
