title: [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.affiliation: Service de médecine interne et cardiovasculaire, CHU de la 1re faculté de médecine, université Charles, U nemocnice 2, 12800 Prague 2, Czech Republic.
authors.forename: M
authors.initials: M
authors.lastname: Chochola
authors.forename: J-C
authors.initials: JC
authors.lastname: Lubanda
authors.forename: L
authors.initials: L
authors.lastname: Skalicka
authors.forename: P
authors.initials: P
authors.lastname: Varejka
authors.forename: J
authors.initials: J
authors.lastname: Horejs
authors.forename: T
authors.initials: T
authors.lastname: Prskavec
authors.forename: M
authors.initials: M
authors.lastname: Balík
authors.forename: M
authors.initials: M
authors.lastname: Semrád
authors.forename: A
authors.initials: A
authors.lastname: Linhart
mesh_terms: D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D000868:Anterior Compartment Syndrome / Q000000981:diagnostic imaging / Q000209:etiology*; D001219:Aspartate Aminotransferases / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism; D003404:Creatinine / Q000097:blood; D005260:Female; D005360:Fibula / Q000000981:diagnostic imaging / Q000294:innervation; D007839:Functional Laterality; D006801:Humans; D007511:Ischemia / Q000000981:diagnostic imaging / Q000209:etiology; D007866:Leg / Q000098:blood supply; D018482:Muscle, Skeletal / Q000000981:diagnostic imaging; D009135:Muscular Diseases / Q000139:chemically induced / Q000150:complications* / Q000601:surgery; D009211:Myoglobin / Q000097:blood; D009212:Myoglobinuria / Q000209:etiology; D019821:Simvastatin / Q000009:adverse effects*; D013977:Tibia / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D009211:Myoglobin; D002097:C-Reactive Protein; D019821:Simvastatin; D003404:Creatinine; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase