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Cardiovascular diseases are a major global health concern, with statin therapy playing a significant role in primary and secondary prevention. Statin-associated muscle symptoms typically occur early in treatment, but severe rhabdomyolysis is a rare complication. We present an unprecedented case of a patient who developed severe rhabdomyolysis with acute kidney injury after 10 years of uninterrupted statin therapy.

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Statins are among the most widely prescribed drugs for treating dyslipidemia and reducing the incidence of heart disease and stroke. However, they come with a wide range of side effects, from myopathy to necrotizing rhabdomyolysis, as well as diabetes, hepatotoxicity, and sleep problems. The most common side effect of statins is statin-induced myopathy, often leading to discontinuation of statin therapy and noncompliance in many patients.

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Atorvastatin-induced Myositis and Drug-induced Liver Injury.

J Assoc Physicians India

October 2023

Junior Resident, Department of Geriatric Medicine, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India.

Statins are drugs for preventing cardiac events in the elderly population. Statins are well tolerated with a lower reported incidence of serious side effects (<0.15%) like myopathy and elevated transaminases [>3× upper limit of normal (ULN)].

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Background: Clinical pharmacogenetic implementation guidelines for statin therapy are derived from evidence of primarily Eurocentric study populations. Functional variants that are rare in these study populations have not been investigated as a determinant of statin myotoxicity and are thus missing from guideline inclusion.

Objective: Determine the relationship between candidate functional variants and statin-induced myopathy in people with recent genealogical ancestors from Africa.

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Inflammatory myositis (IM) presents a diagnostic challenge due to its multifaceted etiology and varying clinical presentations. This case involves a 55-year-old male with asymptomatic hypothyroidism, recent statin use, and rapidly progressing proximal muscle weakness. He presented with profound weakness in the upper and lower extremities, severely impairing his daily activities.

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