Shinde Varsha, Penmetsa Pranay, Nair Karthik R, Dixit Yash
Emergency Medicine, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth (Deemed to be University), Pune, IND.
Cureus. 2024 Aug 8;16(8):e66483. doi: 10.7759/cureus.66483. eCollection 2024 Aug.
Statins are widely used to manage dyslipidemia and prevent cardiovascular diseases due to their effectiveness and general safety profile. However, they can sometimes cause severe muscle-related adverse effects, presenting diagnostic challenges when symptoms overlap with other conditions. This case report describes a middle-aged woman who presented to the emergency department with bilateral lower limb weakness, initially suggesting Guillain-Barré syndrome (GBS). Despite her history of low-grade fever and diarrhea, primary and secondary surveys, including electrocardiogram, blood gas analysis, and nerve conduction studies, showed no definitive signs of GBS. The patient had a recent history of percutaneous transluminal coronary angioplasty and was on dual antiplatelet therapy and rosuvastatin. Elevated creatine kinase levels and exclusion of other differential diagnoses led to the diagnosis of statin-induced myopathy, a rare but severe adverse effect of statins. The patient was treated with intravenous fluids, cessation of statins, and sessions of hemodialysis and plasmapheresis, resulting in significant improvement and eventual recovery of muscle power and neurological function. This case highlights the importance of recognizing statin-induced myopathy in patients with muscle weakness and emphasizes the need for thorough clinical evaluation to differentiate it from other conditions such as GBS. Further research is warranted to understand the pathophysiology of statin myopathy and identify at-risk populations.
他汀类药物因其有效性和总体安全性,被广泛用于治疗血脂异常和预防心血管疾病。然而,它们有时会引起严重的肌肉相关不良反应,当症状与其他疾病重叠时,会带来诊断挑战。本病例报告描述了一名中年女性,她因双侧下肢无力就诊于急诊科,最初疑似吉兰-巴雷综合征(GBS)。尽管她有低热和腹泻病史,但包括心电图、血气分析和神经传导研究在内的初步和二次检查均未发现GBS的确切体征。该患者近期有经皮冠状动脉腔内血管成形术史,正在接受双重抗血小板治疗和服用瑞舒伐他汀。肌酸激酶水平升高以及排除其他鉴别诊断后,确诊为他汀类药物引起的肌病,这是他汀类药物一种罕见但严重的不良反应。患者接受了静脉输液、停用他汀类药物以及多次血液透析和血浆置换治疗,肌肉力量和神经功能得到显著改善并最终恢复。本病例强调了在肌肉无力患者中识别他汀类药物引起的肌病的重要性,并强调需要进行全面的临床评估以将其与GBS等其他疾病区分开来。有必要进一步研究以了解他汀类药物肌病的病理生理学并确定高危人群。