Zaraa Inés Rania, Labbène Imen, Mrabet Dalila, Zribi Hela, Chelly Inès, Zitouna Mohamed, Mokni Mourad, Sellami Slaheddine, Ben Osman Amel
Department of Dermatology, La Rabta Hospital, Tunis, Tunisia.
BMJ Case Rep. 2011 Mar 29;2011:bcr0220113832. doi: 10.1136/bcr.02.2011.3832.
Dermatomyositis (DM) is a rare inflammatory autoimmune disease for which an iatrogenic origin has been described in a few cases. The authors report a case of DM occurring after simvastatin intake. A 50-year-old male sought medical attention for a photodistributed rash and considerable muscular weakness present for 3 months. One year earlier, simvastatin had been introduced. Serum creatine kinase levels were elevated. Histological examination of a muscle biopsy was consistent with a diagnosis of DM. Investigation for neoplasia and associated autoimmune disease proved negative. All clinical and laboratory abnormalities diminished corticosteroid therapy (1 mg/kg/day). Case reports have suggested that lipid-lowering drugs, especially statins, could induce or reveal chronic muscle diseases. In statins myopathy, reduction of coenzyme Q has been discussed as a key mechanism. Our case of DM in a patient receiving simvastatin adds to the previous reported cases in the literature and highlights the potential role of statins as triggers of immune systemic diseases.
皮肌炎（DM）是一种罕见的炎症性自身免疫性疾病，少数病例中已描述有医源性病因。作者报告了一例服用辛伐他汀后发生的皮肌炎病例。一名50岁男性因光分布性皮疹和持续3个月的明显肌肉无力前来就医。一年前开始服用辛伐他汀。血清肌酸激酶水平升高。肌肉活检的组织学检查结果与皮肌炎诊断相符。肿瘤形成及相关自身免疫性疾病的检查结果均为阴性。所有临床和实验室异常在皮质类固醇治疗（1毫克/千克/天）后减轻。病例报告表明，降脂药物，尤其是他汀类药物，可能诱发或揭示慢性肌肉疾病。在他汀类药物所致肌病中，辅酶Q的减少被认为是关键机制。我们报告的这例服用辛伐他汀后发生皮肌炎的病例补充了文献中先前报道的病例，并突出了他汀类药物作为免疫性系统性疾病触发因素的潜在作用。
