Letter to the Editor

Systemic Infections Can Decrease the Threshold of Statin-induced Muscle Injury

Authors: Sohail K. Mahboobi, MD, Ephron Z. Shohat, MD, Samantha P. Jellinek, PharmD, BCPS, Malcolm Rose, MD

Abstract

To the Editor:We read with interest the report of Finsterer and Zuntner1 describing the possible relationship between rhabdomyolysis, statin therapy and systemic infection. We report a similar occurrence in a patient with septicemia. There are various risk factors described which increase the likelihood of statin-induced muscle injury, but little is known about the significance of systemic infections in this state. We report a case of atorvastatin-induced severe acute muscle injury leading to acute renal failure in a patient who had enterococcal bacteremia.

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References

1. Finsterer J, Zuntner G. Rhabdomyolysis from simvastatin triggered by infection and muscle exertion.South Med J 2005;98:827–829.
 
2. Ucar M, Mjorndal T, Dahlqvist R. HMG-CoA reductase inhibitors and myotoxicity. Drug Saf2000;22:441–457.
 
3. Flint OP, Masters BA, Gregg RE, Durham SK. HMG-CoA inhibitor-induced myotoxicity: pravastatin and lovastatin inhibit the geranylgeranyolation of low-molecular-weight proteins in neonatal rat muscle cell culture. Toxicol Appl Pharmacol 1997;145:99–110.
 
4. Betrosian A, Thireos E, Kofinas G, et al. Bacterial sepsis-induced rhabdomyolysis. Intensive Care Med 1999;25:469–474.
 
5. Liappis AP, Kan VL, Rochester CG, Simon GL. The effect of statins on mortality in patients with bacteremia. Clin Infect Dis 2001;33:1352–1357.