Department of Internal Medicine, Hallym University Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, Korea.
Department of Internal Medicine, Hallym University Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Korea.
Endocrinol Metab (Seoul). 2013 Dec;28(4):331-4. doi: 10.3803/EnM.2013.28.4.331. Epub 2013 Dec 12.
Rhabdomyolysis is a syndrome involving the breakdown of skeletal muscle that causes myoglobin and other intracellular proteins to leak into the circulatory system, resulting in organ injury including acute kidney injury. We report a case of statin-induced rhabdomyolysis and acute kidney injury that developed in a 63-year-old woman with previously undiagnosed hypothyroidism. Untreated hypothyroidism may have caused her hypercholesterolemia requiring statin treatment, and it is postulated that statin-induced muscle injury was aggravated by hypothyroidism resulting in her full-blown rhabdomyolysis. Although this patient was successfully treated with continuous venovenous hemofiltration and L-thyroxin replacement, rhabdomyolysis with acute kidney injury is a potentially life-threatening disorder. Physicians must pay special attention to the possible presence of subclinical hypothyroidism when administering statins in patients with hypercholesterolemia.
横纹肌溶解症是一种涉及骨骼肌破裂的综合征,导致肌红蛋白和其他细胞内蛋白质泄漏到循环系统中,从而导致包括急性肾损伤在内的器官损伤。我们报告了一例他汀类药物诱导的横纹肌溶解症和急性肾损伤病例,该病例发生在一位 63 岁患有未确诊甲状腺功能减退症的女性中。未经治疗的甲状腺功能减退症可能导致她需要他汀类药物治疗的高胆固醇血症,据推测,甲状腺功能减退症引起的肌肉损伤加剧了他汀类药物诱导的肌肉损伤,导致她出现全面的横纹肌溶解症。尽管该患者通过连续静脉-静脉血液滤过和 L-甲状腺素替代治疗成功治疗,但横纹肌溶解症伴急性肾损伤是一种潜在的危及生命的疾病。当给患有高胆固醇血症的患者开他汀类药物时,医生必须特别注意可能存在亚临床甲状腺功能减退症。