A RARE CASE OF STATIN-INDUCED NECROTIZING AUTOIMMUNE MYOPATHY

AACE Clinical Case Reports
Shirley Shuster, Sara Awad

Abstract

Necrotizing autoimmune myopathy (NAM) is a rare side-effect of statin therapy. We report the case of a patient who developed statin-induced NAM with a review of the clinical presentation and management of this rare entity. The case illustrates the importance of including NAM in the differential diagnosis of persistent myopathy in a statin-exposed individual. A 74-year-old male was referred to endocrinology for hypercholesterolemia management in the context of a statin contraindication. He previously developed myositis and rhabdomyolysis secondary to statin therapy, but continued to have persistent proximal lower limb muscle weakness despite statin discontinuation. Rheumatologic and metabolic work-up were negative and neurologic work-up was negative except for a myopathic pattern in the glutei found on electromyography. Due to the persistence of proximal myopathy despite statin discontinuation and myopathic pattern seen on electromyography, NAM was suspected and antibodies against 3-hydroxy-3-methylglutaryl-coenzyme A reductase were sent and came back positive. The patient was treated with the immunosuppressant azathioprine, which resulted in clinical improvement. The patient was started on a proprotein convertase subtilisin/kex...Continue Reading

References

Apr 10, 2015·Journal of General Internal Medicine·Laura NicholsChamindra G Konersman
Jul 21, 2015·JAMA Neurology·Charles D KassardjianMargherita Milone
Feb 24, 2018·Expert Review of Clinical Immunology·Albert Selva-O'CallaghanJosep María Grau-Junyent

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