Atorvastatin associated with gamma glutamyl transpeptidase elevation in a hyperlipidemia patient: A case report and literature review.

Abstract

RATIONALE:

Atorvastatin is the most common drug used in therapy for cardiovascular diseases. The most common adverse side effects associated with statins are myopathy and hypertransaminasemia. Here, we report a rare case of gamma glutamyl transpeptidase (GGT) elevation induced by atorvastatin.

PATIENT CONCERNS:

A 47-year-old male was admitted to our hospital with dyslipidemia, he had been taking pitavastatin 2 mg/day for 2 months. The levels of total cholesterol (265.28 mg/dL) and low-density lipoprotein-cholesterol (LDL) (179.15 mg/dL) were also high.

DIAGNOSIS:

Blood lipid test showed mixed dyslipidemia.

INTERVENTION:

Atorvastatin 10 mg/day was given to the patient.

OUTCOMES:

The patient came back to our hospital for blood tests after 4 weeks. Although no symptoms were detectable, the patient's GGT level was markedly elevated (up to 6-fold over normal level) with less marked increases in alkaline phosphatase (ALP) and alanine aminotransferase (ALT). The serum GGT level returned to normal within 6 weeks of cessation of atorvastatin.

LESSONS:

This is a case of GGT elevation without hyperbilirubinemia, hypertransaminasemiam, or serum creatine phosphokinase (CPK) abnormalities despite an atorvastatin regimen. This case highlights GGT elevation caused by atorvastatin, a rare but serious condition. Clinicians should be aware of these possible adverse effects and monitor liver function tests in patients on statin therapy.

• Authors: Yan Xu, Yanqing Wu
• Journal: Medicine (Medicine (Baltimore)) Vol. 99 Issue 40 Pg. e22572 (Oct 02 2020) ISSN: 1536-5964 [Electronic] United States
• PMID: 33019469 (Publication Type: Case Reports, Journal Article, Review)

Chemical References

• Cholesterol, HDL
• Cholesterol, LDL
• Hydroxymethylglutaryl-CoA Reductase Inhibitors
• Lipids
• Quinolines
• Atorvastatin
• gamma-Glutamyltransferase
• Alanine Transaminase
• Alkaline Phosphatase
• pitavastatin

Topics

• Alanine Transaminase (blood)
• Alkaline Phosphatase (blood)
• Atorvastatin (administration & dosage, adverse effects, therapeutic use)
• Cardiovascular Diseases (drug therapy)
• Cholesterol, HDL (blood)
• Cholesterol, LDL (blood)
• Dyslipidemias (diagnosis, drug therapy)
• Humans
• Hydroxymethylglutaryl-CoA Reductase Inhibitors (administration & dosage, adverse effects, therapeutic use)
• Lipids (blood)
• Male
• Middle Aged
• Quinolines (administration & dosage, adverse effects, therapeutic use)
• Withholding Treatment
• gamma-Glutamyltransferase (blood, drug effects)