Rosuvastatin
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Guyon canal syndrome: case report A 49-year-old woman developed Guyon canal syndrome of the right hand during treatment with rosuvastatin for hypercholesterolemia. The woman had been receiving treatment with rosuvastatin [for 4 years; route and dosage not stated] for hypercholesterolemia, and chlormadinone (for several years) for endometriosis. She presented for consultation due to a motor deficit of the right hand involving the abduction of the fifth finger, with the secondary appearance of painful paraesthesia of the fifth finger with a type of burn, which she noted 6 weeks prior. Physical examination showed weakness of the interosseous muscles and a discrete amyotrophy of the hypothenarian muscles, concerning the muscles of the forearm, a permanent spacing of the fifth finger, without any sensory deficit. Palpation of the ulnar nerve in the elbow and wrist was painless. Motor impairment of the hand muscles indicated compression of the ulnar nerve at the wrist. An electromyoneurography demonstrated a distal decrease in amplitude of the motor action potential of the right ulnar nerve, associated with an increase in distal motor latency, without any alteration of the associated sensory potential, and electromyographic signs of neuropathic damage to the interosseous and hypothenar muscles during detection and hypothenar muscles during detection. Based on the examinations, a diagnosis of Guyon canal syndrome was considered. All other laboratory tests showed normal results. An MRI of the wrist revealed a cystic formation located in the proximal and palmar part of the fourth intermetacarpal space of the right hand, but with no compression of the ulnar nerve at the level of the Guyon canal. Based on literature search and ruling out compression as a cause of the condition, long term rosuvastatin therapy was considered as the causative factor. Consequently, the man’s rosuvastatin therapy was stopped. Within 2 weeks, significant improvement was noted in her condition with resolution of the pain and motor deficits. Electromyoneurography showed disappearance of the signs of electrical pain. The causal relationship according to the French method was C2S2 indicating a plausible chronological and semiological criteria. Bugnicourt J-M, et al. Guyon canal syndrome: Think statins! Journal de Pharmacie Clinique 39: 167-170, No. 3, Sep 2020. Available from: URL: https://www.jle.com/en/ 803512208 revues/jpc/e-docs/syndrome_canalaire_des_membres_superieurs_pensez_statines__318486/article.phtml [French; summarised from a translation]
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Reactions 31 Oct 2020 No. 1828
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