Judicious Evaluation of Adverse Drug Reactions: Inaccurate Assessment of 3‐hydroxy‐3‐methylglutaryl Coenzyme A Reductase Inhibitor‐Induced Muscle Injury

Abstract

Adverse reactions in two patients who received HMG CoA reductase inhibitor therapy were reinvestigated because of their rarity. A case of permanent forearm myalgia was thought to be caused by atorvastatin. Closer evaluation and work-up revealed underlying lateral epicondylitis, and atorvastatin was not considered the cause of the disability. In another patient, rhabdomyolysis was suspected to be secondary to simvastatin. However, after an extensive review, the reaction was believed to be compartment syndrome of the anterior tibial area. An adverse drug reaction report requires careful and judicious assessment to assign the correct probability for the event.

Spontaneous compartment syndrome in association with simvastatin-induced myositis

“…One was in a patient with newly diagnosed hypothyroidism,4 a known cause of spontaneous compartment syndrome. The second, a review of a patient originally diagnosed with rhabdomyolysis5 and the final case a result of drug interaction between simvastatin and risperidone 6…”

Risk-benefit of HMG-CoA reductase inhibitors in the treatment of HIV protease inhibitor-related hyperlipidaemia

“…Bietz and Oberg describe cases of myalgia and rhabdomyolysis that were inaccurately attributed to atorvastatin and simvastatin [84]. The true underlying diagnoses proved to be lateral epicondylitis and compartment syndrome.…”

Spontaneous compartment syndrome in a patient with diabetes and statin administration: a case report

“…The most frequent cause of acute compartment syndrome (ACS) is linked to traumatic injuries of both the bone and the soft tissues [ 2 ]. However, surgery can lead to ACS due to an erroneous position of the patient on the operating table, for trendelenburg, prolonged hypotension or a specific operation, such as intramedullary osteosynthesis [ 3 , 4 ].…”