Statin-induced bilateral foot drop in a case of hypothyroidism

• Published in: Annals of the Indian Academy of Neurology Vol. 18; no. 3; pp. 331 - 334
• Main Authors: Chaudhary, Neera, Duggal, Ashish Kumar, Makhija, Prashant, Puri, Vinod, Khwaja, Geeta Anjum
• Format: Journal Article
• Language: English
• Published: India Medknow Publications and Media Pvt. Ltd 01.07.2015; Medknow Publications & Media Pvt. Ltd; Medknow Publications & Media Pvt Ltd; Wolters Kluwer Medknow Publications
• Subjects: Anterior tibial compartment syndrome; Care and treatment; Case Report; Cholesterol; Complications and side effects; Development and progression; Feet; foot drop; Footdrop; Hypothyroidism; Lipids; Mortality; NMR; Nuclear magnetic resonance; Pain; Patients; Physiological aspects; Statins; Urine; Anterior tibial compartment syndrome; statins; foot drop
• ISSN: 0972-2327; 1998-3549
• DOI: 10.4103/0972-2327.157251

Muscle involvement is a common manifestation of both clinical and subclinical hypothyroidism, with serum creatine kinase (CK) elevation being probably the most common manifestation, and is seen in up to 90% of patients, but is usually mild (less than 10 times the upper limit of normal). Rhabdomyolysis is a distinctively uncommon presentation of hypothyroidism described usually in the setting of precipitating events such as strenuous exercise, alcohol, or statin use. Rarely rhabdomyolysis and myoedema seen in hypothyroidism can be complicated by the development of anterior compartment syndrome leading to neurovascular compression. We describe a case of a patient with hypothyroidism who developed acute onset bilateral foot drop on initiation of statins. This case highlights the need for cautious use of statins in patients at risk for rhabdomyolysis.