Presymptomatic neuromuscular disorders disclosed following statin treatment

[Guest guest]

Arch Intern Med. 2006 Jul 24;166(14):1519-24.

Presymptomatic neuromuscular disorders disclosed following statin

treatment.

Tsivgoulis G, Spengos K, Karandreas N, Panas M, Kladi A, Manta P.

Department of Neurology, University of Athens Medical School,

Eginition Hospital, Athens, Greece.

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.