Delayed Recognition of Statin-Induced Immune-Mediated Necrotizing Myopathy in an Older Adult
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Abstract
Statins, widely used for cardiovascular prevention, may rarely induce immune-mediated necrotizing myopathy (IMNM), a severe and potentially disabling condition. We describe a 79-year-old woman with hypertension, dyslipidemia, and obesity who developed progressive proximal weakness and persistent creatine kinase (CPK) elevation after statin discontinuation. Infectious, neoplasms and systemic autoimmune causes were excluded. Strong anti-HMGCR antibody positivity, combined with magnetic resonance imaging (MRI) and electromyographic evidence of inflammatory necrosis, confirmed statin-associated IMNM. The patient improved with corticosteroids, intravenous immunoglobulin (IGIV), and methotrexate. This case highlights the importance of recognizing IMNM in statin users with unexplained weakness and sustained CPK elevation, as early immunosuppressive therapy can prevent long-term disability.
This case highlights the importance of recognizing IMNM in statin users with unexplained weakness and sustained CPK elevation, as early immunosuppressive therapy can prevent long-term disability.
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