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瑞舒伐他汀诱导横纹肌溶解导致急性肾损伤和四肢瘫——病例报告

Acute Kidney Injury and Quadriparesis Due to Rosuvastatin Induced Rhabdomyolysis- A Case Report.

作者信息

Suthar Kamlesh S, Vanikar Aruna V, Trivedi Hargovind L

机构信息

Assistant Professor, Department of Pathology, Laboratory Medicine, Transfusion Services and Immunohematology, G.R. Doshi and K.M. Mehta Institute of Kidney Diseases and Research Centre and Dr. H.L. Trivedi Institute of Transplantation Sciences (IKDRC-ITS) , Ahmedabad, India .

Professor, Department of Pathology, Laboratory Medicine, Transfusion Services and Immunohematology, G.R. Doshi and K.M. Mehta Institute of Kidney Diseases and Research Centre and Dr. H.L. Trivedi Institute of Transplantation Sciences (IKDRC-ITS) , Ahmedabad, India .

出版信息

J Clin Diagn Res. 2015 May;9(5):OD08-9. doi: 10.7860/JCDR/2015/12117.5909. Epub 2015 May 1.

Abstract

Statins as lipid lowering drugs, are safe and effective in reducing cardiovascular disease risk, but rarely produce myopathy like myalgia, myositis or rhabdomyolysis. We report the case of Rosuvastatin induced rhabdomyolytic acute renal failure and quadriparesis in a 67-year old male, a known case of type-2 diabetes mellitus and with a history of coronary angioplasty four months back. He was on antihypertensive, oral hypoglycemic and antiplatelet medications with Rosuvastatin 40mg/day. He was admitted with altered sensorium, breathlessness, vomiting, muscle weakness and decreased urine output and had raised serum creatinine, creatinine phosphokinase and myoglobin. After ruling out all other causation for rhabdomyolysis, we stopped Rosuvastatin and started supportive management and hemodialysis. Patient showed gradual recovery in renal function and quadriparesis. Patient was discharged with good urine output and on antihypertensive, hypoglycemic drug and diet restrictions for lipid control. He recovered completely and had normal renal function with well controlled lipid level on follow up of 6 months after discharge. Thus, prompt diagnosis of Rhabdomyolysis due to Rosuvastatin in absence of other aetiology and the multidisciplinary management can prevent further complication with favorable outcome.

摘要

他汀类药物作为降脂药物,在降低心血管疾病风险方面安全有效,但很少引起如肌痛、肌炎或横纹肌溶解等肌病。我们报告了一例67岁男性患者,他患有2型糖尿病且4个月前有冠状动脉血管成形术史,服用瑞舒伐他汀后发生横纹肌溶解性急性肾衰竭和四肢瘫痪。他正在服用抗高血压药、口服降糖药和抗血小板药物,同时服用40mg/天的瑞舒伐他汀。他因意识改变、呼吸困难、呕吐、肌肉无力和尿量减少入院,血清肌酐、肌酸磷酸激酶和肌红蛋白升高。在排除所有其他导致横纹肌溶解的病因后,我们停用了瑞舒伐他汀并开始支持治疗和血液透析。患者肾功能和四肢瘫痪逐渐恢复。患者出院时尿量良好,继续服用抗高血压药、降糖药,并进行饮食限制以控制血脂。出院6个月随访时,他完全康复,肾功能正常,血脂水平得到良好控制。因此,在没有其他病因的情况下及时诊断瑞舒伐他汀引起的横纹肌溶解,并进行多学科管理,可以预防进一步的并发症并取得良好的结果。

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