A 68-year-old woman with familial hyper-cholesterolemia and osteoarthritis was treated with atorvastatin 10 mg daily for four months, ending in October 2006. At that time, hypothyroidism was diagnosed, and the atorvastatin was temporarily discontinued. She returned to our lipid clinic in September 2009, because her total and low-density-lipoprotein [LDL] cholesterol levels were significantly increased. At this point, rosuvastatin 10 mg daily was started.Two weeks after starting the rosuvastatin, the patient noticed a strong fish odour, similar to a problem she had experienced before menopause. When she was nine years old, she had undergone investigation for a strong odour of rotting fish, for which she was ostracized by her classmates. The smell had decreased after puberty, but she still noticed a strong fishy smell around the time of her menstrual periods and when she was eating a choline-rich diet, such as fish and eggs. The smell had disappeared after menopause.
展开▼
