Presymptomatic neuromuscular disorders disclosed following statin treatment
Presymptomatic neuromuscular disorders disclosed following statin treatment
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DOI：
10.1001/archinte.166.14.1519
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发表时间：
2006-07-24
影响因子：
--
通讯作者：
Manta, Panagiota
中科院分区：
文献类型：
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作者：
Tsivgoulis, Georgios;Spengos, Konstantinos;Manta, Panagiota
众所周知，他汀类药物对肌肉组织有不良影响，其使用与临床上重要的肌炎、横纹肌溶解、血清肌酸激酶（CK）水平轻度升高、肌痛、肌无力、肌肉痉挛和持续性肌痛或停止他汀类药物治疗后血清CK水平升高相关。他汀类药物与症状前代谢性肌病的相关性是另一个被低估的现象，与他汀类药物治疗有关，最近在罕见病例中被认识到。本报告的目的是为这种关联提供额外的支持，并报告在他汀类药物摄入后也观察到的其他神经肌肉疾病。目前的病例系列说明，他汀类药物可能作为解蔽剂在无症状患者的潜伏性神经肌肉疾病。因此，可以假设，他汀类药物摄入可能是一个足够的侮辱，沉淀神经肌肉症状和显着增加肌酶与异常的神经肌肉基质的前驱患者。总之，停止他汀类药物治疗后持续存在的肌肉症状或血清CK水平升高应提醒临床医生进一步进行诊断评价，以检测潜在的潜在神经肌肉疾病。
It is well recognized that statins affect muscular tissue adversely and that their use is associated with clinically important myositis, rhabdomyolysis, mild elevation of serum creatine kinase (CK) levels, myalgias, muscle weakness, muscle cramps, and persistent myalgias or serum CK level elevations after statin treatment is discontinued. The association between statins and the disclosure of presymptomatic metabolic myopathy is another underrated phenomenon related to statin therapy that was recently recognized in rare cases. The purpose of this report is to provide additional support for this association and to report other neuromuscular disorders that have also been seen following statin intake. The present case series illustrates that statins may act as unmasking agents in asymptomatic patients with a latent neuromuscular disorder. Thus, it may be postulated that statin intake may be a sufficient insult to precipitate neuromuscular symptoms and substantially increase muscle enzymes in presymptomatic patients with an abnormal neuromuscular substrate. In conclusion, muscular symptoms or increased serum CK levels persisting after statin treatment discontinuation should alert the clinician to pursue further diagnostic evaluations for the detection of potential underlying neuromuscular diseases.