STATIN- INDUCED AUTOIMMUNE NECROTIZING MYOPATHY: REPORT OF A CASE AND LITERATURE REVIEW

Abstract

Statins can cause a variety of muscle diseases, most of which are self-limited after discontinuation of the offending agent. Rarely, an autoimmune necrotizing myopathy develops that persists after statin withdrawal. Specific autoantibody testing can help identify these patients and direct their treatment.
We report a 76 years old woman with history of statin use, who was admitted to our hospital for persistence of muscle weakness and elevated muscle enzymes, despite statin discontinuation 6 months before admission. Muscle biopsy demonstrated myofiber’s degeneration and necrosis, and there was significant improvement after methylprednisolone initiation. The diagnosis of statin-induced autoimmune necrotizing myositis was confirmed by the detection of anti-HMGCR antibodies in patient’s serum. Immunosuppressive therapy was continued, resulting in symptoms remission.