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Protocols cure diseases, not patients: flaccid paresis in post-NSTEMI statin treatment.

Abstract
An 82-year-old white woman presented at our Internal Medicine ward with flaccid tetraparesis. Two months earlier, she had suffered a non-ST elevation myocardial infarction treated with percutaneous coronary intervention (PCI) and stenting, and she had been prescribed the classical post-PCI therapy (β-blockers, statins and antiplatelet agents). At admission, she was haemodynamically stable and the physical examination revealed reduced reflexes in the four limbs. Urgent laboratory findings revealed mild hypokalaemia. Considering the high statin doses she was taking, we also performed an urgent creatine phosphokinase test, which indicated rhabdomyolysis. Statin therapy was immediately stopped and aggressive fluid treatment begun, supplemented with potassium for increased urinary potassium losses. The patient progressively regained muscle strength.
AuthorsJavier Rosada, Eleni Rebelos, Stefania Petruccelli, Marco Taddei
JournalBMJ case reports (BMJ Case Rep) Vol. 2015 (Apr 22 2015) ISSN: 1757-790X [Electronic] England
PMID25903205 (Publication Type: Case Reports, Journal Article)
Copyright2015 BMJ Publishing Group Ltd.
Chemical References
  • Adrenergic beta-Antagonists
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • Platelet Aggregation Inhibitors
  • Atorvastatin
Topics
  • Adrenergic beta-Antagonists (therapeutic use)
  • Aged, 80 and over
  • Atorvastatin (adverse effects)
  • Female
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors (adverse effects)
  • Myocardial Infarction (therapy)
  • Paresis (chemically induced, diagnosis)
  • Percutaneous Coronary Intervention
  • Platelet Aggregation Inhibitors (therapeutic use)
  • Rhabdomyolysis (chemically induced, diagnosis)
  • Stents

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