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Amyotrophic lateral sclerosis after one-year medication of cannabinoid receptor antagonist: A case of iatrogenic ALS?

Marcello Zanna

Am J Case Rep 2008; 9:333-337

ID: 865124

Background: A cannabinoid (CB) receptor antagonist, rimonabant, is a new promising agent in the treatment of atherosclerosis and other disorders including alcoholism. In experiments, CB receptor agonist protects the onset and progression of neurodegenerative diseases such as amyotrophic lateral sclerosis (ALS), characterized clinically by progressive devastating systemic muscle weakness and atrophy.
Case Report: A 61-year-old woman taking thyroid hormone and calcium after thyroid resection received rimonabant during 12 months for clinical trial of lipid lowering. During the trial, she developed muscle cramps, and a few months later after the end of rimonabant medication, she developed weakness in the both legs, extending progressively systemic muscle weakness and atrophy. One year later, neurological wouk-up including electromyogram and neuroimagings demonstrated both lower and upper motor neuron sings and a cognitive dysfunction of the frontal lobe, indicating a clinical diagnosis of definite ALS. The patient has gradually worsened to ambulatory diffi culty 15 months after the end of rimonabant medication.
Conclusions: This patient may represent the first case having ALS after medication of CB receptor antagonist. The further follow-up data will address a definitive conclusion.

Keywords: rimonabant, Amiotrofic lateral sclerosis, blood calcium

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