Statin-induced, immune-mediated necrotising myopathy triggered by malignancy successfully treated with immunosuppression

Ahmed Abouelazm; Kirollos Philops; Amr Amine; Yahia Golam

doi:10.1016/j.clinme.2024.100217

Statin-induced, immune-mediated necrotising myopathy triggered by malignancy successfully treated with immunosuppression

Clin Med (Lond). 2024 May 6;24(3):100217. doi: 10.1016/j.clinme.2024.100217. Online ahead of print.

Authors

Ahmed Abouelazm¹, Kirollos Philops², Amr Amine³, Yahia Golam⁴

Affiliations

¹ Portsmouth University Hospital, UK. Electronic address: Ahmed.Abouelazm@porthosp.nhs.uk.
² Portsmouth University Hospital, UK. Electronic address: Kirollos.Philops@porthosp.nhs.uk.
³ Portsmouth University Hospital, UK. Electronic address: Amr.Amin@porthosp.nhs.uk.
⁴ Portsmouth University Hospital, UK. Electronic address: Golam.Yahia@porthosp.nhs.uk.

Abstract

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.

Keywords: Dysphagia; Glucocorticoid; Methotrexate; Myopathy; Myositis; Statins.

Publication types

Case Reports