Resolved question:
Hi I had a drug eluding stent fitted to my LAD in april last year (brand 'Promus' coated with everolimus). Almost immediately (within say 1 week of being discharged from hospital) I started suffering from severe muscle pain in my back (which MRI's showed nothing out of order), suffering from parethesis in my feet and hands while I was sleeping (I would wake up and start moving them again and they would be ok for a while and then it would happen again). The symptoms are like carpel tunnel and tarsel tunnel if you like.
Other symtpoms I have noticed include:-
# excessive sweating from only mild exercise (I never used to sweat much at all, even when exercising hard)
# hands super sensitive, go bright red when showering and white when cold (never had this problem before)
# fatigue and headaches (never been an issue before)
All the above I have been blaming on the statins I took for 5 months (as they were commenced straight after the stent was fitted) but having been off them now for over 1 year and also people suffering from neuropathy from statins is only 1 in 1000 I have always thought the odds were long on myself having an adverse reaction to the statins (and also for it have happend so quickly also made me sceptical I guess).
Given that the symptons haven't changed at all (no worse or no better) I have done some research on patients reactions after 'stenting' and some have recorded similar symptoms to me and they have discovered that they are probably having reactions to the metal from the stents.
I have spent a lot of money ruling out anythling like B12 defency, diabetes, thryroid etc etc and the only things I haven't crossed off my list is a possible reaction to the metal that the stent is made from to explain all thse adverse reacftions happneing in my body (prior to the stent I was in perfect health, apart from a high cholsterol which was I wasn't aware off that probably led to the plaque build up).
Do you think it's possible that my body is 'rejecting' the stent and all these symptoms are related to this as there is no other plausible explanation at this point in time. I am anxious to get to the bottom of a cause mainly because I really need to be on the statins but I have held off for the past 12 months trying to see if I can get my body to 're-set' itself so I can 'rechallenge' myself on the statins (on al ower dose) and see how I go but unfortunately have never had any relief from the symptoms that started in April last year.
SHould I see an immunologist and can he test me to see perhaps I am alergic to the metals that my stent is made from???
Submitted:
4 Days
Category:
Cardiologist
Hello,
Thank you for your query at DoctorSpring.com.
It is highly unlikely that statins will produce neuropathy or hypersensitivity. So we can rule out that option (especially since the symptoms persist even after the drug withdrawal). They are known to produce myopathy. Muscle pain may be explained by this. That can be confirmed by doing levels of CK total or ck nac in blood.
There are no available reports or research of metal allergy or polymer allergy. Moreover the symptoms are not very suggestive of allergy or immunological reaction. Especially the back pain and the parasthesis This is more suggestive of a peripheral neuropathy or nerve compression.
I am not saying that 'there is no published data so it cannot be happen'. But rather I am putting it this way. Yes there is theoretical probability that stent can elicit a immunological or allergic reaction. But the symptoms are not at all characteristic of such reaction ( those symptoms will be more wide spread, systemic involving the skin ). There is a possibility of immune complex reactions but it is too long shot.
Another thing that has to be considered is to the medications that were started with the PCI procedure. These medications can have certain side effects. For example diuretics make you feel fatigued, nitrates can give you headaches. So the confounding drug side effects need to be ruled out. A hear failure can make you feel fatigued.
I do not really recommend visit an Immunologist, because it won’t change or have an impact on the outcome. It will not be conclusively possible to find out whether the stent is causing a reaction. In any case removal of the stent is not a very reasonable option either. So you will be back to square one. Instead I recommend a Neurology consult to see about the back pain and numbness and to rule out peripheral neuropathy by doing a nerve conduction study.
Review the medications, accessing the cardiac status, Neurological evaluation and Symptomatic treatment will be the best way to move forward IMHO.
Hope this helps
Please do ask followup questions / clarification if you have any. I will be glad to help.