[Bilateral leg compartment syndrome due to severe myonecrosis caused by inappropriate use of simvastatin].

Abstract

Bilateral leg compartment syndrome due to myonecrosis caused by inappropriate use of statins is a rare but potentially fatal complication of this lipid lowering medication. We report a case of a 39-year-old woman who presented with suspicious critical lower limb ischemia. Subsequently, bilateral leg compartment syndrome and myonecrosis developed. The primary cause of myonecrosis was due to misuse of simvastatin mistaken by the patient for a weight-reducing drug. Urgent fasciotomies were performed and the patient underwent urgent renal replacement therapy with continuous hemodialysis for acute renal failure due to myoglobinuria. After this complex treatment, the patient was discharged. She almost fully recovered with only a residual paresis of the left fibular nerve. According to literature, this is a unique case of bilateral compartment syndrome and myonecrosis with acute renal failure due to statin overdose leading to acute renal failure and bilateral fasciotomy.

• Authors: M Chochola, J-C Lubanda, L Skalicka, P Varejka, J Horejs, T Prskavec, M Balík, M Semrád, A Linhart
• Journal: Journal des maladies vasculaires (J Mal Vasc) Vol. 33 Issue 4-5 Pg. 229-33 (Dec 2008) ISSN: 0398-0499 [Print] France
• Vernacular Title: Syndrome de compression des loges bilatéral des membres inférieurs et myonécrose sévère due à l'usage inapproprié de la simvastatine.
• PMID: 18819764 (Publication Type: Case Reports, Journal Article)

Chemical References

• Myoglobin
• C-Reactive Protein
• Simvastatin
• Creatinine
• Aspartate Aminotransferases
• Alanine Transaminase

Topics

• Adult
• Alanine Transaminase (blood)
• Anterior Compartment Syndrome (diagnostic imaging, etiology)
• Aspartate Aminotransferases (blood)
• C-Reactive Protein (metabolism)
• Creatinine (blood)
• Female
• Fibula (diagnostic imaging, innervation)
• Functional Laterality
• Humans
• Ischemia (diagnostic imaging, etiology)
• Leg (blood supply)
• Muscle, Skeletal (diagnostic imaging)
• Muscular Diseases (chemically induced, complications, surgery)
• Myoglobin (blood)
• Myoglobinuria (etiology)
• Simvastatin (adverse effects)
• Tibia (diagnostic imaging)
• Tomography, X-Ray Computed
• Treatment Outcome