Statin-Associated Necrotizing Autoimmune Myositis Complicated by an Uncommon Adverse Effect to Treatment
Statin-associated necrotizing autoimmune myositis (NAM) is an autoimmune condition characterized by severe acute-onset proximal muscle weakness, a very high creatinine kinase (CK) level, and prominent myofiber necrosis and minimal lymphocytic infiltration on muscle biopsy. Unlike self-limited statin...
Saved in:
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2019-01-01
|
| Series: | Case Reports in Medicine |
| Online Access: | http://dx.doi.org/10.1155/2019/4601304 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832552176150380544 |
|---|---|
| author | Brian M. Fung Emil R. Heinze Andrew L. Wong |
| author_facet | Brian M. Fung Emil R. Heinze Andrew L. Wong |
| author_sort | Brian M. Fung |
| collection | DOAJ |
| description | Statin-associated necrotizing autoimmune myositis (NAM) is an autoimmune condition characterized by severe acute-onset proximal muscle weakness, a very high creatinine kinase (CK) level, and prominent myofiber necrosis and minimal lymphocytic infiltration on muscle biopsy. Unlike self-limited statin myopathy, this condition usually requires aggressive immunomodulation therapy to assist recovery and prevent future disability. In this case report, we present a patient who developed progressive muscle weakness after taking atorvastatin for one year. At initial presentation, her CK level was 28,000 U/L. She was diagnosed with statin-associated NAM and started on high-dose intravenous solumedrol, mycophenolate, and intravenous immunoglobulin (IVIG) therapy. However, she subsequently developed acute bilateral vision loss and right side hemineglect; she was diagnosed with posterior reversible encephalopathy syndrome (PRES), thought to be a possible delayed adverse reaction to IVIG. IVIG was discontinued, and the patient was treated with supportive therapy. At six-month follow-up, she had significant improvement in muscle strength and vision. |
| format | Article |
| id | doaj-art-ad1998798b5f4e55a487ba5ae093ba43 |
| institution | Kabale University |
| issn | 1687-9627 1687-9635 |
| language | English |
| publishDate | 2019-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Medicine |
| spelling | doaj-art-ad1998798b5f4e55a487ba5ae093ba432025-02-03T05:59:20ZengWileyCase Reports in Medicine1687-96271687-96352019-01-01201910.1155/2019/46013044601304Statin-Associated Necrotizing Autoimmune Myositis Complicated by an Uncommon Adverse Effect to TreatmentBrian M. Fung0Emil R. Heinze1Andrew L. Wong2UCLA-Olive View Internal Medicine Residency Program, Sylmar, CA, USADivision of Rheumatology, Department of Medicine, Olive View-UCLA Medical Center, Sylmar, CA, USADivision of Rheumatology, Department of Medicine, Olive View-UCLA Medical Center, Sylmar, CA, USAStatin-associated necrotizing autoimmune myositis (NAM) is an autoimmune condition characterized by severe acute-onset proximal muscle weakness, a very high creatinine kinase (CK) level, and prominent myofiber necrosis and minimal lymphocytic infiltration on muscle biopsy. Unlike self-limited statin myopathy, this condition usually requires aggressive immunomodulation therapy to assist recovery and prevent future disability. In this case report, we present a patient who developed progressive muscle weakness after taking atorvastatin for one year. At initial presentation, her CK level was 28,000 U/L. She was diagnosed with statin-associated NAM and started on high-dose intravenous solumedrol, mycophenolate, and intravenous immunoglobulin (IVIG) therapy. However, she subsequently developed acute bilateral vision loss and right side hemineglect; she was diagnosed with posterior reversible encephalopathy syndrome (PRES), thought to be a possible delayed adverse reaction to IVIG. IVIG was discontinued, and the patient was treated with supportive therapy. At six-month follow-up, she had significant improvement in muscle strength and vision.http://dx.doi.org/10.1155/2019/4601304 |
| spellingShingle | Brian M. Fung Emil R. Heinze Andrew L. Wong Statin-Associated Necrotizing Autoimmune Myositis Complicated by an Uncommon Adverse Effect to Treatment Case Reports in Medicine |
| title | Statin-Associated Necrotizing Autoimmune Myositis Complicated by an Uncommon Adverse Effect to Treatment |
| title_full | Statin-Associated Necrotizing Autoimmune Myositis Complicated by an Uncommon Adverse Effect to Treatment |
| title_fullStr | Statin-Associated Necrotizing Autoimmune Myositis Complicated by an Uncommon Adverse Effect to Treatment |
| title_full_unstemmed | Statin-Associated Necrotizing Autoimmune Myositis Complicated by an Uncommon Adverse Effect to Treatment |
| title_short | Statin-Associated Necrotizing Autoimmune Myositis Complicated by an Uncommon Adverse Effect to Treatment |
| title_sort | statin associated necrotizing autoimmune myositis complicated by an uncommon adverse effect to treatment |
| url | http://dx.doi.org/10.1155/2019/4601304 |
| work_keys_str_mv | AT brianmfung statinassociatednecrotizingautoimmunemyositiscomplicatedbyanuncommonadverseeffecttotreatment AT emilrheinze statinassociatednecrotizingautoimmunemyositiscomplicatedbyanuncommonadverseeffecttotreatment AT andrewlwong statinassociatednecrotizingautoimmunemyositiscomplicatedbyanuncommonadverseeffecttotreatment |