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Statin-Induced Autoimmune Myopathy.
Curēus 2021 Februrary 27
Statins are one of the most widely prescribed drugs in the world. One of the common side effects of statin use is myopathy. We report a case of statin-induced autoimmune myopathy, which is a variant of statin-induced myopathy. A 56-year-old female with a history of hypertension, hyperlipidemia, cerebral aneurysm status post clipping, and seizure disorder presented with progressive muscle weakness. Her initial laboratory results demonstrated an elevated creatine phosphokinase (CPK) of 17,144 IU/L. The patient's atorvastatin was discontinued and she was placed on high-rate intravenous fluids; however, despite this, her CPK remained elevated. Patient underwent further blood testing for specific autoimmune etiologies. As there was high concern for autoimmune myositis, she was started on high-dose steroids. Anti-3-hydroxy-3-methylglutaryl-coenzyme A (anti-HMG-CoA) reductase antibody returned strongly positive. While the patient was on steroids, her muscle weakness and CPK level gradually improved. She was discharged on oral steroids. Statin-induced autoimmune myopathy should be considered with high suspicion when there is a significantly elevated CPK level. Discontinuation of statin therapy does not lead to muscle recovery or improvement in the CPK level. Diagnosis is confirmed by positive anti-HMG-CoA reductase autoantibody and a muscle biopsy.
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