Rhabdomyolysis induced by Lipid-Lowering Agents

Abstract

Statins are patent cholesterol-lowering agents that have been widely used in the patients with hyperlipidemia. Despite having good safety and efficacy profiles, adverse effects on skeletal muscle that may proceed to rhabdomyolysis have been rarely described. Fibric asit derivates can cause a similar syndrome and the coadministration of statins with fibric asit derivates can also increase the risk of myopathy. We describe two female patients who had rabdomyolysis and myopathy associated with concurrent use of statins (provastatin, simvastatin) and gemfibrozil after different periods of treatment (1 year and 1 month, respectively). The patients' clinical picture was similar with diffuse weakness prominent in proximal limb, facial and neck weakness. Light microscopic findings of deltoid muscle revealed non-specific myoptic changes. Full recovery occurred gradually with cessation of lipid-lowering agents (LLA). The history of taking LLA should be considered in any patient with muscle pain, proximal weakness, elevated CK levels and myoglobinuria.