Statin-induced immune-mediated necrotising myopathy (IMNM) is an inflammatory myopathy that can present as proximal muscle weakness and, in some cases, as dysphagia and respiratory distress. In this report, we present a case of statin-induced IMNM in a 78-year-old male. The patient had significantly high levels of creatinine kinase and myoglobinuria and experienced gradual weakness in the proximal muscles for 1 month after initiating a 20 mg dose of Atorvastatin 10 months before admission. Rapid clinical improvement was observed with the use of high-dose glucocorticoids in conjunction with methotrexate.
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http://dx.doi.org/10.1016/j.clinme.2024.100217 | DOI Listing |
JCEM Case Rep
December 2024
Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Mayo Clinic, Rochester, MN 55905, USA.
The widespread use of statins for cardiovascular diseases has unveiled a new subset of inflammatory myopathy, immune-mediated necrotizing myopathy (IMNM). We describe below an unusual case of anti-3-hydroxy-3-methylglutaryl-coenzyme A reductase (anti-HMGCR) myopathy. A 64-year-old male individual with type 2 diabetes, hyperlipidemia, and coronary artery disease presented with progressive proximal muscle weakness and pain for 3 months.
View Article and Find Full Text PDFUgeskr Laeger
October 2024
Afdeling for Hjertesygdomme, Sygehus Sønderjylland, Aabenraa.
Statin-induced immune-mediated necrotising myopathy (IMNM) is a rare complication associated with statin use. IMNM is classified as one of the inflammatory myopathies characterised by myalgia and elevated serum creatine kinase (CK) levels. In this case report, we present a 58-year-old woman who developed IMNM secondary to atorvastatin use.
View Article and Find Full Text PDFCureus
October 2024
Internal Medicine, Jefferson Einstein Montgomery Hospital, East Norriton, USA.
Statins, commonly used for hyperlipidemia and more importantly having proven efficacy in lowering cardiovascular risk, are a very popular class of medications. Side effects are usually mild, and the class as a whole is generally well-tolerated by patients. However, one rare and more serious side effect is statin-induced autoimmune necrotizing myopathy.
View Article and Find Full Text PDFActa Clin Belg
September 2024
Neurology Department, Cliniques Universitaires Saint-Luc, Brussels, Belgium.
Immune-mediated necrotizing myopathy (IMNM) is a rare type of auto-immune myositis, characterized by symmetric muscle pain, proximal weakness, elevated serum CK levels and pathologic findings of necrotized muscle fibers. IMNM may be seronegative, associated with anti-signal recognition particle (SRP) antibodies or anti-hydroxy-3-methylglutaryl-CoA reductase (HMGCR) antibodies, the last widely related with statin use. This last entity affects only 2 to 3 of 100,000 patients under statins.
View Article and Find Full Text PDFGeriatr Gerontol Int
July 2024
Department of Neurology, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan.
An 81-year-old woman presented with statin-induced anti-HMGCR immune-mediated necrotizing myopathy. Treatment was successful without complications with a reduced oral steroid dosage from the current consensus for all ages and backgrounds. This case suggests the importance of early diagnosis and the possibility of steroid dosage adjustment considering the patient's age, disease severity, and comorbidities.
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