Statin-associated rhabdomyolysis: an exemplary case report and a mini-review of therapeutic management.

Abstract

Background: Familial hypercholesterolemia (FH) is a genetic disorder that significantly increases low-density lipoprotein cholesterol (LDL-C) levels. Statins are commonly prescribed to minors to improve overall cardiovascular outcomes. Despite their well-documented efficacy in lowering lipid levels, statins can cause adverse side effects, including myopathy and, in rare cases, rhabdomyolysis.

Case description: A 17-year-old male adolescent presented with acute muscle pain in both arms. The patient had a history of FH and was undergoing treatment with rosuvastatin. Laboratory results revealed a marked elevation in creatine kinase (CK), myoglobin, cystatin C, and hepatic enzymes. Urinalysis did not show any abnormalities. Given the suspicion of statin-associated rhabdomyolysis, rosuvastatin was promptly discontinued. Further, the patient was administered intravenous fluids (3 L/m²/day) for renal protection. Nine days after admission, levels of CK, myoglobin, and creatinine returned to normal. Hepatic enzymes and cystatin C remained elevated. The patient was advised to discontinue statin therapy for a total of 6 weeks. For further treatment, the patient was referred to a pediatric lipid clinic.

Conclusions: While the use of statins is generally safe, rare side effects including rhabdomyolysis must be detected and therapy promptly initiated to prevent long-term health effects. Patients that experienced statin-associated rhabdomyolysis should be monitored closely and referred to a pediatric lipid clinic for further treatment.