P25 | An expected case of severe rhabdomyolysis

E. Branca¹, E. Pisciotta², G. Michelis¹, M.R. Marcialis¹, M. Ventura¹, E. Laurita¹ | ¹Ospedale degli Inferimi, Rivoli, (TO), ²Oncologia Medica, Ospedale S. Luigi, Orbassano (TO), Italy

Background: Statins currently represent one of the most effective therapy for the prevention of cardiovascular diseases, but they are not immune to adverse effects, including myalgia, hepatotoxicity and rhabdomyolysis. Statin-induced rhabdomyolysis is an uncommon, but life-threatening adverse effect. It is a clinical syndrome characterized by destruction of skeletal muscle tissue, often associated with renal failure. We describe a case of rhabdomyolysis induced by rosuvastatin in association with ezetimibe.
Case report: A 77-year-old man was admitted to our hospital with generalized body aches, muscle weakness, worsening myalgia in the lower limbs for two weeks with an inability to walk and hyporexia. He was started on high-intensity rosuvastatina/ezetimibe (40mg/10 mg) a months prior to admission. At the beginning the blood tests showed a severe increase in creatinine (9.37 mg/dL), in CPK (99520 U/L) and in myoglobin (>4000ng/mL). A basic workup excluded other possible causes. The patient suspended immediately statins and was subjected to three-weekly hemodialysis and started hydrating and alkalinizing therapy, with a diagnosis of acute renal failure in the course of statin-induced rhabdomyolysis. At discharge, the renal function was at medium-advanced values, with resolution of the clinical symptoms.
Conclusions: Statin-induced rhabdomyolysis is a rare but serious complication. Prescribing high-intensity statins for patients with advanced age may increase the risk of rhabdomyolysis and other complications. Care must be taken when prescribing statin therapy.