Kiernan Thomas J, Rochford Martin, McDermott John H
Int J Cardiol. 2007 Jul 31;119(3):374-6. doi: 10.1016/j.ijcard.2006.07.233. Epub 2006 Nov 13.
An 85-year-old woman with renal impairment and hypothyroidism was commenced on high dose simvastatin (80 mg) for better lipid control. Shortly after this she developed severe muscular weakness and laboratory evidence of rhabdomyolysis. Despite having hypothyroidism controlled for years with L-thyroxine (100 mcg), her biochemistry now reflected a hypothyroid state with inadequate thyroid replacement. On discontinuing her simvastatin to treat her rhabdomyolysis, the patient's TSH level decreased to normal within 4 weeks without any change in L-thyroxine dosage. To our knowledge this is only the second case reported in the literature of a rare but important interaction between simvastatin and L-thyroxine and the first case reported with associated rhabdomyolysis.
一名85岁患有肾功能损害和甲状腺功能减退的女性开始服用高剂量辛伐他汀（80毫克）以更好地控制血脂。此后不久，她出现了严重的肌肉无力以及横纹肌溶解的实验室证据。尽管她多年来一直使用左甲状腺素（100微克）控制甲状腺功能减退，但她现在的生化指标显示甲状腺替代不足，处于甲状腺功能减退状态。在停用辛伐他汀以治疗她的横纹肌溶解后，患者的促甲状腺激素（TSH）水平在4周内降至正常，而左甲状腺素的剂量没有任何变化。据我们所知，这是文献中报道的辛伐他汀与左甲状腺素之间罕见但重要相互作用的第二例，也是首例伴有横纹肌溶解的病例。
