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Atorvastatin/suxamethonium-chloride Myalgia: case report

A 70-year-old man developed myalgia during treatment with atorvastatin for hyperlipidaemia, and following administration of suxamethonium-chloride [durations of treatments to reactions onsets not stated and not all dosages and routes stated]. The man was admitted with an acute, severe and diffuse myalgias, which limited his ability to ambulate. Two days prior to the current presentation, he had undergone a diagnostic excisional biopsy for diffuse lymphadenopathy. He received IV suxamethonium-chloride [succinylcholine] 80mg, fentanyl and propofol for rapid sequence intubation. The procedure lasted for about one hour and he was discharged on the same day. His medical history was significant for hyperlipidaemia, coronary artery disease and hypertension. He had been receiving atorvastatin for more than 10 years and his other medications included metoprolol, ramipril and aspirin [acetylsalicylic acid]. At the current presentation, he reported paralysing muscle pains with diffuse weakness. He was unable to ambulate due to the pain. The pain was dull and it exacerbated by movement. The symptoms had started 24 hours prior to the current presentation and were more severe in proximal muscle groups. On physical examination his heart rate was 78 beats per minute, blood pressure was 127/81 mmHg, oxygen saturation was 100% and he was afebrile. Neurological examination revealed normal muscle tone, normal sensation in all dermatomes and normal symmetric reflexes. Motor examination indicated diffuse symmetric weakness in his lower upper extremities, which may have been due to significant pain. He had no effusion, redness or swelling of articulations. The biopsy site surgical incision appeared to be healing well. After reviewing his complete medical record, a diagnosis of suxamethonium-chloride induced myalgia was suspected. The man showed significant improvement over the next 24 hours without any treatment and he was discharged. Later, he experienced complete recovery without any residual myalgia or weakness. It was reported that treatment with atorvastatin also contributed to the development of myalgia. Simard C, et al. A paralyzing case of myalgias. American Journal of Case Reports 21: e922568, Jan 2020. Available from: URL: http://doi.org/10.12659/ AJCR.922568

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Reactions 22 Aug 2020 No. 1818