Effect of long term simvastatin administration as an adjunct to ursodeoxycholic acid: evidence for a synergistic effect on biliary bile acid composition but not on serum lipids in humans.

Background: Stimulated bile acid synthesis preferentially utilises newly synthesised cholesterol, raising the possibility that combination of simvastatin (an inhibitor of cholesterol synthesis) with ursodeoxycholic acid (UDCA; a stimulator of bile acid synthesis) may result in reduced bile acid synthesis and greater enrichment of the pool with UDCA than that achieved with UDCA treatment alone.

Aims: To investigate the effect of simvastatin and UDCA given alone and in combination on serum and biliary lipid and biliary bile acid composition.

Methods: Eighteen patients with primary non-familial hypercholesterolaemia were studied during treatment with simvastatin 20 mg/day, UDCA 10 mg/kg/day, and a combination of the two drugs.

[Pheochromocytoma with multiple localizations manifested by a hemorrhagic bladder tumor].

Pheochromocytoma is an endocrine tumor derived from neuroectodermal tissue. Pheochromocytomas usually arises in the adrenal glands but may develop in other organs. We report a case of pheochromocytoma of the bladder with hematuria as the presenting symptom.