Suppr超能文献

一种类似神经病的病症:表现为吉兰-巴雷综合征的他汀类药物诱导性肌病

A Neuropathy Mimic: Statin-Induced Myopathy Presenting as Guillain-Barré Syndrome.

作者信息

Shinde Varsha, Penmetsa Pranay, Nair Karthik R, Dixit Yash

机构信息

Emergency Medicine, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth (Deemed to be University), Pune, IND.

出版信息

Cureus. 2024 Aug 8;16(8):e66483. doi: 10.7759/cureus.66483. eCollection 2024 Aug.

Abstract

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.

摘要

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。

相似文献

1
A Neuropathy Mimic: Statin-Induced Myopathy Presenting as Guillain-Barré Syndrome.
Cureus. 2024 Aug 8;16(8):e66483. doi: 10.7759/cureus.66483. eCollection 2024 Aug.
2
Statin-Induced Autoimmune Myopathy: A Diagnostic Challenge in Muscle Weakness.
Am J Case Rep. 2024 Sep 2;25:e944261. doi: 10.12659/AJCR.944261.
3
Unveiling the Rare Complication: Statin-Induced Immune-Mediated Necrotizing Myopathy.
Am J Case Rep. 2023 Dec 13;24:e941387. doi: 10.12659/AJCR.941387.
4
Statin-Associated Bilateral Foot Myopathy.
J Pharm Pract. 2020 Dec;33(6):899-902. doi: 10.1177/0897190019857851. Epub 2019 Jun 27.
5
Challenges in the diagnosis and management of immune-mediated necrotising myopathy (IMNM) in a patient on long-term statins.
Rheumatol Int. 2023 Feb;43(2):383-390. doi: 10.1007/s00296-022-05230-0. Epub 2022 Oct 19.
7
Concurrent Guillain-Barré syndrome and myositis complicating dengue fever.
BMJ Case Rep. 2020 Feb 10;13(2):e232940. doi: 10.1136/bcr-2019-232940.
8
A systematic review and economic evaluation of statins for the prevention of coronary events.
Health Technol Assess. 2007 Apr;11(14):1-160, iii-iv. doi: 10.3310/hta11140.
9
Case report: A 33 years-old alcoholic male with diarrhea and progressive muscle weakness mimicking Guillain-Barré syndrome.
Front Neurol. 2023 Aug 7;14:1212497. doi: 10.3389/fneur.2023.1212497. eCollection 2023.
10
Statin-Induced Autoimmune Myopathy.
Cureus. 2021 Feb 26;13(2):e13576. doi: 10.7759/cureus.13576.

本文引用的文献

1
Interpretation of the evidence for the efficacy and safety of statin therapy.
Lancet. 2016 Nov 19;388(10059):2532-2561. doi: 10.1016/S0140-6736(16)31357-5. Epub 2016 Sep 8.
2
Diagnosis of Guillain-Barré syndrome and validation of Brighton criteria.
Brain. 2014 Jan;137(Pt 1):33-43. doi: 10.1093/brain/awt285. Epub 2013 Oct 26.
3
Statin induced myopathy.
BMJ. 2008 Nov 6;337:a2286. doi: 10.1136/bmj.a2286.
4
New insights into mechanisms of statin-associated myotoxicity.
Curr Opin Pharmacol. 2008 Jun;8(3):333-8. doi: 10.1016/j.coph.2007.12.010. Epub 2008 Feb 1.
5
Distribution of creatine kinase in the general population: implications for statin therapy.
Am Heart J. 2007 Oct;154(4):655-61. doi: 10.1016/j.ahj.2007.06.008.
6
Safety of aggressive lipid management.
J Am Coll Cardiol. 2007 May 1;49(17):1753-62. doi: 10.1016/j.jacc.2007.01.067. Epub 2007 Apr 16.
9
Current overview of statin-induced myopathy.
Am J Med. 2004 Mar 15;116(6):408-16. doi: 10.1016/j.amjmed.2003.10.033.

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍。

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索

文档翻译

学术文献翻译模型,支持多种主流文档格式。

立即体验