Acute Kidney Injury and Quadriparesis Due to Rosuvastatin Induced Rhabdomyolysis- A Case Report

Statin-Associated Necrotizing Myopathy Leading to Acute Kidney Injury: A Case Report

Statins or 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors are a mainstay of cardiovascular disease therapy. In addition to their lipid-lowering capabilities, they exhibit several pleiotropic effects. Their adverse reactions such as myalgias are not uncommon, but in rare cases, the resulting rhabdomyolysis can be fatal. Recently, more insight has been brought into the pathogenesis of statin-induced rhabdomyolysis, and immune-mediated necrotizing myopathies are diagnosed more frequently. We present a case of a female patient who was on chronic rosuvastatin therapy and developed necrotizing myopathy. The disease progressed to acute kidney and liver injury. We discontinued the drug, started supportive measures, and initiated renal replacement therapy with a high cutoff dialysis membrane once. Her recovery was prompt, with a normal control electromyography 2 weeks after discharge.

Effect of rosuvastatin on vascular endothelial functions and inflammatory factors of patients with type 2 diabetes mellitus and coronary heart disease

Effects of rosuvastatin on vascular endothelial functions and inflammatory factors of patients with type 2 diabetes mellitus and coronary heart disease were investigated. Eighty patients with type 2 diabetes mellitus and coronary heart disease, who were admitted and treated in Center hospital of Zibo from January 2016 to January 2017, were selected and divided into observation group (n=40) and control group (n=40) by the random number table; symptomatic and supporting therapy, including use of metformin, captopril, asprin and levocarnitine, was used in control group while rosuvastatin was adopted in observation group in addition to the symptomatic and supporting therapy. Patients in both groups were treated for a treatment cycle, namely, 3 consecutive months. After that, indexes related to blood lipid, diabetes mellitus and vascular endothelial activity, as well as variations in inflammation-associated cytokines, before and after intervention were compared; the correlation of changes in total cholesterol (TC) with those in fasting insulin (FINS), high-sensitivity C-reactive protein (hs-CRP) and endothelin-1 (ET-1), respectively, was analyzed. Among the blood lipid indexes of the patients, the levels of TC, triglyceride (TG) and low-density lipoprotein cholesterol (LDL-C) after intervention were significantly lower than those before intervention (P<0.05), while the post-intervention level of high-density lipoprotein cholesterol (HDL-C) was higher than that before intervention (P<0.05). Compared with those before intervention, the level of FINS after intervention was remarkably higher (P<0.05), while the homeostasis model assessment of insulin resistance (HOMA-IR) level after intervention was significantly lower (P<0.05). After intervention, the levels of hs-CRP and tumor necrosis factor-α (TNF-α) in the patients were obviously decreased compared with those before intervention (P<0.05). Compared with that before intervention, the ET-1 level was decreased (P<0.05), while the nitric oxide (NO) level was elevated after intervention (P<0.05). The TC level was negatively correlated with FINS level (P<0.05) but positively correlated with the levels of hs-CRP (P<0.05) and ET-1 (P<0.05). For patients with type 2 diabetes mellitus and coronary heart disease, treatment with rosuvastatin can effectively lower the level of blood lipid and regulate insulin functions; moreover, potent decrease in blood lipid level has great significance in improving the vascular endothelial functions and reducing inflammatory response levels.