Statin induced myopathy: Difference between revisions

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==Definition==
==Definition==
Statin induced myopathy is a spectrum of muscular problems caused by the intake of statin. Myopathy by definition is the abnormal function of the muscle.
The spectrum of statin induced myopathy includes:
====Myalgia====
* Myalgia is defined as one or combination of muscle weakness, tenderness or pain.
* Patients usually complain of cramping feeling in the muscles.
* Creatine kinase may be normal or minimally elevated.
====Asymptomatic increase in creatine kinase====
====Myositis====
* Myositis is the inflammation of the muscle characterised by muscular complaints in the setting of elevated creatine kinase up to ten folds.
====Rhabdomyositis====
* Rhabdomyositis 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 rhabdomyosistis similarly to myositis.
* The complications of rhabdomyositis 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====
* 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>


==Prevalence==
==Prevalence==

Revision as of 02:07, 28 November 2012

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Rim Halaby

Overview

Definition

Statin induced myopathy is a spectrum of muscular problems caused by the intake of statin. Myopathy by definition is the abnormal function of the muscle. The spectrum of statin induced myopathy includes:

Myalgia

  • Myalgia is defined as one or combination of muscle weakness, tenderness or pain.
  • Patients usually complain of cramping feeling in the muscles.
  • Creatine kinase may be normal or minimally elevated.

Asymptomatic increase in creatine kinase

Myositis

  • Myositis is the inflammation of the muscle characterised by muscular complaints in the setting of elevated creatine kinase up to ten folds.

Rhabdomyositis

  • Rhabdomyositis 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 rhabdomyosistis similarly to myositis.
  • The complications of rhabdomyositis are acute tubular necrosis, hypocalcemia, hyperkalemia, metabolic acidosis, hyperuricemia, DIC and cardiomyopathy.[1]

Other Statin Induced Myopathies

  • Elevated creatine kinase after statin withdrawal[2]
  • Autoimmune myopathy requiring immunosuppressive therapy[3]

Prevalence

Risk Factors

Pathophysiology

Treatment

References

  1. Baker, S.K. & Tarnopolsky, M.A. (2001). Statin myopathies: pathophysiologic and clinical perspectives. Clin. Invest. Med., 24(5): 258-272.
  2. Thompson PD, Clarkson P, Karas RH (2003). "Statin-associated myopathy". JAMA. 289 (13): 1681–90. doi:10.1001/jama.289.13.1681. PMID 12672737.
  3. Radcliffe KA, Campbell WW (2008). "Statin myopathy". Curr Neurol Neurosci Rep. 8 (1): 66–72. PMID 18367041.