Statin induced myopathy classification: Difference between revisions
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==Overview== | ==Overview== | ||
[[Statin induced myopathy]] is a spectrum of muscular problems caused by the intake of [[statins]]. [[Myopathy]] is, by definition, any pathology of the [[muscle]]. | [[Statin induced myopathy]] is a spectrum of muscular problems caused by the intake of [[statins]]. [[Myopathy]] is, by definition, any pathology of the [[muscle]]. | ||
The spectrum of [[statin induced myopathy]] can be classified into: [[myalgia]], asymptomatic increase in [[creatine kinase]], [[myositis]] and [[rhabdomyolysis]]. | The spectrum of [[statin induced myopathy]] can be classified into: [[myalgia]], asymptomatic increase in [[creatine kinase]], [[myositis]] and [[rhabdomyolysis]].<ref name="pmid12672737">{{cite journal| author=Thompson PD, Clarkson P, Karas RH| title=Statin-associated myopathy. | journal=JAMA | year= 2003 | volume= 289 | issue= 13 | pages= 1681-90 | pmid=12672737 | doi=10.1001/jama.289.13.1681 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12672737 }} </ref><ref name="pmid18367041">{{cite journal| author=Radcliffe KA, Campbell WW| title=Statin myopathy. | journal=Curr Neurol Neurosci Rep | year= 2008 | volume= 8 | issue= 1 | pages= 66-72 | pmid=18367041 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18367041 }} </ref> | ||
==Classification== | ==Classification== | ||
====Myalgia==== | ====Myalgia==== | ||
* [[Myalgia]] is defined as one or combination of symptoms of muscle weakness, tenderness or pain in the context of normal or minimally elevated [[creatinine kinase]]. | * [[Myalgia]] is defined as one or combination of symptoms of muscle weakness, tenderness or pain in the context of a normal or minimally elevated [[creatinine kinase]] level. | ||
* Patients usually complain of cramping feeling in the muscles. | * Patients usually complain of cramping feeling in the muscles. | ||
| Line 17: | Line 18: | ||
====Myositis==== | ====Myositis==== | ||
* [[Myositis]] is the inflammation of the muscle. | * [[Myositis]] is the inflammation of the muscle. | ||
* [[Myositis]] is defined as the presence of symptoms of muscle weakness, tenderness or pain in the setting of an [[elevated creatine kinase]] up to ten folds the normal | * [[Myositis]] is defined as the presence of symptoms of muscle weakness, tenderness or pain in the setting of an [[elevated creatine kinase]] up to ten folds the upper limits of normal. | ||
====Rhabdomyolysis==== | ====Rhabdomyolysis==== | ||
* [[Rhabdomyolysis]] is the acute degeneration of the [[skeletal muscle]]. | * [[Rhabdomyolysis]] is the acute degeneration of the [[skeletal muscle]]. | ||
* It is a potentially lethal condition due to its associated nephrotoxicity caused by myoglobinuria and myoglobinemia. | * It is a potentially lethal condition due to its associated nephrotoxicity caused by myoglobinuria and myoglobinemia. | ||
* [[Creatine kinase]] is elevated in [[rhabdomyolysis]] more than ten folds the upper normal | * [[Creatine kinase]] is elevated in [[rhabdomyolysis]] more than ten folds the upper limits of normal. | ||
* The complications of [[rhabdomyolysis]] are [[acute tubular necrosis]], [[hypocalcemia]], [[hyperkalemia]], [[metabolic acidosis]], [[hyperuricemia]], [[DIC]] and [[cardiomyopathy]].<ref name="baker">Baker, S.K. & Tarnopolsky, M.A. (2001). Statin myopathies: pathophysiologic and clinical perspectives. Clin. Invest. Med., 24(5): 258-272.</ref> | * The complications of [[rhabdomyolysis]] are [[acute tubular necrosis]], [[hypocalcemia]], [[hyperkalemia]], [[metabolic acidosis]], [[hyperuricemia]], [[DIC]] and [[cardiomyopathy]].<ref name="baker">Baker, S.K. & Tarnopolsky, M.A. (2001). Statin myopathies: pathophysiologic and clinical perspectives. Clin. Invest. Med., 24(5): 258-272.</ref> | ||
====Other Statin Induced Myopathies==== | ====Other Statin Induced Myopathies==== | ||
* Elevated [[creatine kinase]] after [[statin]] withdrawal<ref name="pmid12672737">{{cite journal| author=Thompson PD, Clarkson P, Karas RH| title=Statin-associated myopathy. | journal=JAMA | year= 2003 | volume= 289 | issue= 13 | pages= 1681-90 | pmid=12672737 | doi=10.1001/jama.289.13.1681 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12672737 }} </ref> | * Elevated [[creatine kinase]] after [[statin]] withdrawal.<ref name="pmid12672737">{{cite journal| author=Thompson PD, Clarkson P, Karas RH| title=Statin-associated myopathy. | journal=JAMA | year= 2003 | volume= 289 | issue= 13 | pages= 1681-90 | pmid=12672737 | doi=10.1001/jama.289.13.1681 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12672737 }} </ref> | ||
* Autoimmune myopathy requiring immunosuppressive therapy<ref name="pmid18367041">{{cite journal| author=Radcliffe KA, Campbell WW| title=Statin myopathy. | journal=Curr Neurol Neurosci Rep | year= 2008 | volume= 8 | issue= 1 | pages= 66-72 | pmid=18367041 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18367041 }} </ref> | * Autoimmune myopathy requiring immunosuppressive therapy.<ref name="pmid18367041">{{cite journal| author=Radcliffe KA, Campbell WW| title=Statin myopathy. | journal=Curr Neurol Neurosci Rep | year= 2008 | volume= 8 | issue= 1 | pages= 66-72 | pmid=18367041 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18367041 }} </ref> | ||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
Latest revision as of 20:47, 1 December 2012
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Rim Halaby
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Overview
Statin induced myopathy is a spectrum of muscular problems caused by the intake of statins. Myopathy is, by definition, any pathology of the muscle. The spectrum of statin induced myopathy can be classified into: myalgia, asymptomatic increase in creatine kinase, myositis and rhabdomyolysis.[1][2]
Classification
Myalgia
- Myalgia is defined as one or combination of symptoms of muscle weakness, tenderness or pain in the context of a normal or minimally elevated creatinine kinase level.
- Patients usually complain of cramping feeling in the muscles.
Asymptomatic Increase in Creatine Kinase
Myositis
- Myositis is the inflammation of the muscle.
- Myositis is defined as the presence of symptoms of muscle weakness, tenderness or pain in the setting of an elevated creatine kinase up to ten folds the upper limits of normal.
Rhabdomyolysis
- Rhabdomyolysis is the acute degeneration of the skeletal muscle.
- It is a potentially lethal condition due to its associated nephrotoxicity caused by myoglobinuria and myoglobinemia.
- Creatine kinase is elevated in rhabdomyolysis more than ten folds the upper limits of normal.
- The complications of rhabdomyolysis are acute tubular necrosis, hypocalcemia, hyperkalemia, metabolic acidosis, hyperuricemia, DIC and cardiomyopathy.[3]
Other Statin Induced Myopathies
- Elevated creatine kinase after statin withdrawal.[1]
- Autoimmune myopathy requiring immunosuppressive therapy.[2]
References
- ↑ 1.0 1.1 Thompson PD, Clarkson P, Karas RH (2003). "Statin-associated myopathy". JAMA. 289 (13): 1681–90. doi:10.1001/jama.289.13.1681. PMID 12672737.
- ↑ 2.0 2.1 Radcliffe KA, Campbell WW (2008). "Statin myopathy". Curr Neurol Neurosci Rep. 8 (1): 66–72. PMID 18367041.
- ↑ Baker, S.K. & Tarnopolsky, M.A. (2001). Statin myopathies: pathophysiologic and clinical perspectives. Clin. Invest. Med., 24(5): 258-272.