Investigation for statin intolerance reveals possible Charcot-Marie-Tooth disease in a coronary patient: A case...

Statin regimens are essential for managing lipids and preventing cardiovascular diseases, both in primary and secondary prevention, alongside lifestyle changes. There are, however, some side-effects associated with statin intake, such as an elevation of (CK) and myopathy.

This case describes a coronary patient with high low-density lipoprotein cholesterol (LDL-C) who was undertreated due to elevated creatine kinase (CK) levels and myopathy initially linked to statin use. A proprotein convertase subtilisin/kexin type 9 inhibitor (PCSK9i) replaced statin therapy; however, the existence of persisting/recurrent symptoms or CK elevation posed the need for further investigation. A neurological examination, an electromyography (EMG), and a nerve conduction study (NCV) revealed an underlying sensorimotor polyneuropathy, probably Charcot-Marie-Tooth disease.

Persistent muscle symptoms in patients receiving statins should not be always attributed solely to statin intake. Further neurological evaluation could reveal underlying hereditary sensorimotor polyneuropathies. PCSK9i could serve as the therapy of choice in such cases, as additional drug-induced myopathy could pose severe problems for those patients. HIPPOKRATIA 2023, 27 (4):155-157.