Reactions 1680, p61 - 2 Dec 2017 Statin-associated autoimmune myopathy: case report A 70-year-old man developed statin-associated autoimmune myopathy following treatment with atorvastatin [route and indication not stated]. The man, who sustained a fall at home, was hospitalised to the ICU with large subdural haematoma. He was provided with respiratory support by mechanical ventilation. Before the fall, he had observed elevating pain and weakness positioned bilaterally in the hip girdle region and proximal shoulder. For the past two years, he had been receiving atorvastatin 40mg once daily and aspirin. On presentation, his creatine kinase (CK) level was 12300 IU/L. Atorvastatin was discontinued. In spite of this, the CK continued to be elevated, and there was no improvement in his clinical condition. Needle electromyography findings were suggestive of an active myopathic process with abnormal spontaneous activity. A muscle biopsy demonstrated pausi- immune necrotizing myopathy without any macrophage infiltration,vascular abnormalities and inclusion bodies. Serological testing demonstrated HMG CoA reductase autoantibodies suggestive of an autoimmune process. Based on the clinical and laboratory findings, a diagnosis of statin- associated autoimmune myopathy was made. He was treated with methylprednisolone and rituximab. Although, he continued to be on mechanical ventilation and sedation, improvement was seen in his CK level. Following a mild clinical improvement, he was taken off the ventilator. However, he developed a respiratory distress and underwent a tracheostomy followed by ventilation. Two months after his initial presentation, he was discharged on high dose corticosteroids, rituximab and methotrexate. However, he died three months later due to ventilator-associated pneumonia Author comment: "Herein, we examine a rare but serious case of statin-associated autoimmune myopathy (SAM)." Sweidan AJ, et al. A Case of Statin-Associated Autoimmune Myopathy. Clinical Medicine Insights: Case Reports 10: 1-4, 2017. Available from: URL: http:// doi.org/10.1177/1179547616688231 - USA 803283971 0114-9954/17/1680-0001/$14.95 Adis © 2017 Springer International Publishing AG. All rights reserved Reactions 2 Dec 2017 No. 1680
Reactions Weekly – Springer Journals
Published: Dec 2, 2017
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