American clinicians report their experience with two drugs, sertraline and ranozaline, which have caused cases of lipidosis-type myopathy:
- 10 cases of muscular lipidosis were recorded in the context of exposure to one or other of these drugs,
- the phenotype encountered was predominantly (8/10) that of MADD (acyl-CoA dehydrogenase deficiency),
- in 3 cases of MADD, an underlying genetic cause was documented,
- the cases linked to sertraline had no genetic substrate,
- symptomatic treatment of MADD (with riboflavin and coenzyme Q) combined with discontinuation of the implicated drug was generally beneficial.
The originality of these observations lies in the blurred boundaries between the direct toxicity of these pharmaceutical products and genetic predisposition, where they play a revealing role.
