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Background
Rosuvastatin is a commonly-prescribed lipid-lowering drug. Although several adverse effects occurring under rosuvastatin therapy have been described, we report here a new side effect of rosuvastatin.
Case presentation
A 60-year-old man with elevated low-density lipoprotein (LDL) cholesterol was prescribed rosuvastatin (Crestor) 5 mg daily to treat dyslipidaemia. Medical history was significant for benign prostate hypertrophy, treated with dutasteride (Avodart, 0.5 mg daily) and tamsulosin (Flomax, 0.4 mg daily), as well as arterial hypertension, treated with valsartan (Diovan, 80 mg daily). The man had previously been treated with fenofibrate (Lipidil Supra, 160 mg daily) for hypertriglyceridaemia and the medication was well tolerated. Fenofibrate was withdrawn before rosuvastatin was introduced, as it was deemed more important to lower the LDL cholesterol (3.49 mmol/L), despite triglycerides levels remaining elevated (1.95 mmol/L, with target therapeutic values <1.70 mmol/L).
A few months after the introduction of rosuvastatin therapy, he began experiencing an almost continuous 'sensation of coldness originating from within'. This unusual sensation developed progressively, and eventually reached a point where, even during summer, the patient would have to wear a double pair of wool socks and would sometimes have to cover himself with a blanket while watching TV or reading a book, despite an ambient temperature above 30°C. At night, he would sleep with wool socks and several bed sheets despite an ambient temperature above 25°C. He described this sensation as a being an 'inner sense of coldness that would not respond to increase in ambient temperature, or putting on more clothes, and would affect his whole body, not being limited to the extremities'. This abnormal sensation significantly impaired his quality of life and eventually affected his mood.
Vital signs remained normal. Body temperature was normal, without fever or hypothermia. Physical examination was normal; there was no sign of cardiac, arterial or venous insufficiency. Skin temperature was normal throughout, and was sometimes warm, certainly not cold. There was no...