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他汀类药物治疗十年后发生罕见的他汀诱导横纹肌溶解症并伴有严重急性肾损伤病例

A Rare Case of Statin-Induced Rhabdomyolysis With Severe Acute Kidney Injury After a Decade of Therapy.

作者信息

Okuma Oghenevwede A, Shetty Nikitha, Kapur Priyanka, Ovesuor Christabel, Idahor Courage

机构信息

Internal Medicine, County Durham and Darlington Foundation Trust, Darlington, GBR.

General Internal Medicine, County Durham and Darlington Foundation Trust, Darlington, GBR.

出版信息

Cureus. 2024 Nov 3;16(11):e72913. doi: 10.7759/cureus.72913. eCollection 2024 Nov.

Abstract

Cardiovascular diseases are a major global health concern, with statin therapy playing a significant role in primary and secondary prevention. Statin-associated muscle symptoms typically occur early in treatment, but severe rhabdomyolysis is a rare complication. We present an unprecedented case of a patient who developed severe rhabdomyolysis with acute kidney injury after 10 years of uninterrupted statin therapy. The 10 years of therapy in this case is the longest duration reported in the literature. While several risk factors are associated with its development, including alcohol abuse, our patient's case stands out due to the extended latency of 10 years between statin initiation and rhabdomyolysis onset. Chronic alcohol consumption compounded the diagnostic challenge by masking the symptoms. The pathogenesis involves both muscle toxicity and mitochondrial dysfunction. Timely diagnosis and discontinuation of statin therapy, aggressive hydration, and vigilant monitoring are crucial for managing this life-threatening condition.

摘要

心血管疾病是全球主要的健康问题,他汀类药物治疗在一级和二级预防中发挥着重要作用。他汀类药物相关的肌肉症状通常在治疗早期出现,但严重横纹肌溶解是一种罕见的并发症。我们报告了一例前所未有的病例,该患者在连续服用他汀类药物10年后出现严重横纹肌溶解并伴有急性肾损伤。该病例中的10年治疗时间是文献报道中最长的。虽然有几个风险因素与其发生有关,包括酗酒,但我们患者的病例因其在开始服用他汀类药物和横纹肌溶解发作之间长达10年的延迟而引人注目。长期饮酒通过掩盖症状使诊断挑战更加复杂。发病机制涉及肌肉毒性和线粒体功能障碍。及时诊断和停用他汀类药物治疗、积极补液以及密切监测对于管理这种危及生命的疾病至关重要。

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