Statin neuropathy?
No one connected this patient’s neuropathy to the statin he once took. The connection became clear, though, when he resumed statin therapy and his symptoms worsened.
Managing this patient’s lipid levels going forward
The patient described in this report is now receiving ezetimibe 10 mg daily, which reduces the absorption of cholesterol from the diet, and niacin 2 g daily, which he can tolerate. His most recent fasting lipid panel showed the following results: cholesterol, 171 mg/dL; LDL cholesterol, calculated, 113 mg/dL; HDL cholesterol, 37 mg/dL; triglycerides, 106 mg/dL; and non-HDL cholesterol, 134 mg/dL.
Controlling the patient’s pain was another matter. Drugs commonly used for paresthesia and pain (including opiates) did not provide relief. Pregabalin (Lyrica) also had little effect. Transcutaneous electrical nerve stimulation did not perceptibly lessen his symptoms, and was also discontinued.
At the present time, this patient is not on any specific treatment for his neuropathy.
CORRESPONDENCE
Walter F. Coulson, MD, Department of Pathology, UCLA, CHS, Los Angeles, CA 90095-1732; wcoulson@mednet.ucla.edu
