Elevated Creatine Kinase and Myalgia in a Patient Taking Rosiglitazone
Bibliographic record
Abstract
Objective: To report a case of rosiglitazone-associated elevation in creatine kinase (CK) and coexisting myalgias and review other cases identified in the literature. Case Summary: A 42-year-old man originally from Sri Lanka developed an elevated CK, with peak concentrations of 1671 U/L (normal <160) and myalgias following 5 months of therapy with rosiglitazone. Signs and symptoms recurred upon rechallenge 3 years later. Other potential medical and medication causes were ruled out. Independent assessment by 2 raters using the Naranjo probability scale suggested a probable relationship with rosiglitazone. Discussion: Only 5 previous reports of elevated CK, myalgias, myopathy, or rhabdomolysis in patients taking rosiglitazone or other thiazolidinediones were identified in the literature. Potential risk factors identified from previously published reports included concomitant therapy with fibrates, excessive use of ethanol, and asymptomatic mild CK elevation prior to starting therapy. Based on this case report, it seems reasonable to monitor CK levels in patients on rosiglitazone who are experiencing muscle symptoms or who have a history of myopathy. Conclusions: Marked elevations of CK and muscle pain may be a possible adverse reaction of rosiglitazone therapy.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.003 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".