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Simvastatin-induced erythromelalgia: less is more.

helvella profile image
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Acta Clin Belg. 2019 Jul 10:1-2. doi: 10.1080/17843286.2019.1640929. [Epub ahead of print]

Simvastatin-induced erythromelalgia: less is more.

Vanwonterghem Y1, Shadid S1.

Author information

1 a University Hospital Ghent , Department of Endocrinology , Belgium.

Abstract

We describe a case of a woman with uncomplicated Type 2 diabetes mellitus, presenting with severe burning pains and intense redness of the legs, for which only cooling could provide relief. Although the description was classic of erythromelalgia, the lack of familiarity of the disorder caused considerable doctor's delay as well as the erroneous advice to start pain killers and amitriptyline. However, empirical discontinuation of simvastatin made all symptoms disappear. Erthyromelalgia is a rare but debilitating disease which is diagnosed by exclusion only. It usually occurs as a secondary feature to (hematologic) malignant disorders, autoimmune diseases or, infections or, most notoriously, to pharmacological agents. One of the latter might be simvastatin, and possibly all HMG CoA Reductase inhibitors.

KEYWORDS:

Erthyromelalgia; HMG CoA Reductase inhibitors; adverse drug reaction; side effects; simvastatin; statins

PMID: 31291834

DOI: 10.1080/17843286.2019.1640929

ncbi.nlm.nih.gov/pubmed/312...

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2534 profile image
2534

That’s very interesting. Prof David Jayne said he likes statins which makes me think perhaps there is some contradictory evidence. I have had a 10-15% improvement in my Vasculitis and EM and during that time I introduced simvastatin 2

30 mg without a noticeable difference. Cheers now

helvella profile image
helvella in reply to 2534

Contradictory evidence is not surprising given the multiple possible causes of erythromelalgia itself - and the variation of humans.

In another part of this HU planet, I am involved with thyroid issues and it is so very common to see raised cholesterol (actually lipoprotein, LDL) in those with hypothyroidism. Seems appropriate to check that before considering statins.

2534 profile image
2534 in reply to helvella

I have thyroid -focussed blood tests every 6 moths or so and I don’t think there are thyroid problems but my cholesterol level inc LDL is nicely down after a yr of 30 mg of simvastatin. Incidentally I am taking a maintenance level of Rituximab for the Vasculitis.

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