Gouton M
Hôpital cardiovasculaire et pneumologique Louis-Pradel, Lyon.
Arch Mal Coeur Vaiss. 1993 Dec;86(12):1761-4.
The author report two cases of patients treated for several years for essential hypercholesterolaemia, in whom clinical and biological signs of rhabdomyolosis led to the diagnosis of hypothyroidism. Hormone replacement therapy corrected thyroid function, the muscle enzyme levels and serum cholesterol without associated lipid lowering drugs. All lipid lowering drugs, apart from cholestyramine, can cause rhabdomyolysis, usually by overdosage, renal failure or hypoalbuminaemia. Hypothyroidism is a common cause of rhabomyolysis and hyper-cholesterolaemia and its association with lipid lowering drugs is an additional risk factor for rhabdomyolysis. The cause of rhabdomyolysis may be determined from simple biological tests and this is particularly important because it allows appropriate therapy.
作者报告了两例因原发性高胆固醇血症接受数年治疗的患者，其横纹肌溶解的临床和生物学体征导致了甲状腺功能减退的诊断。激素替代疗法纠正了甲状腺功能、肌肉酶水平和血清胆固醇，且未使用相关降脂药物。除考来烯胺外，所有降脂药物都可能导致横纹肌溶解，通常是由于过量用药、肾衰竭或低白蛋白血症。甲状腺功能减退是横纹肌溶解和高胆固醇血症的常见原因，其与降脂药物的关联是横纹肌溶解的另一个危险因素。横纹肌溶解的病因可通过简单的生物学检测确定，这一点尤为重要，因为它有助于进行适当的治疗。
