A Case Series of Statin-Induced Necrotizing Autoimmune Myopathy

The use of statins has been increasing over the past decade for the primary and secondary prevention of cardiovascular disease worldwide. Subsequently, various side effects have also been unfolding. Muscle-related side effects secondary to statins range from myalgia to rhabdomyolysis and need close...

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Bibliographic Details
Published inCurēus (Palo Alto, CA) Vol. 14; no. 1; p. e21613
Main Authors Sharma, Alisha, Musurakis, Clio, Nabil, Nur Un Nisa, Poudel, Bidhya, Trongtorsak, Angkawipa
Format Journal Article
LanguageEnglish
Published United States Cureus 25.01.2022
Subjects
Allergy/Immunology
Internal Medicine
Neurology
sinam
statin-induced necrotizing autoimmune myopathy
idiopathic rhabdomyolysis
statin
proximal weakness
statin-induced myopathy
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Summary:The use of statins has been increasing over the past decade for the primary and secondary prevention of cardiovascular disease worldwide. Subsequently, various side effects have also been unfolding. Muscle-related side effects secondary to statins range from myalgia to rhabdomyolysis and need close monitoring for early detection. Statin-induced necrotizing autoimmune myopathy (SINAM) in particular is unique given its pathophysiology, trigger factor, genetic predisposition, and aggressive management strategy. We present two cases of SINAM and discuss the clinical aspects of diagnosis, investigation, and management. Statin-induced necrotizing autoimmune myopathy usually presents with proximal myopathy along with increased creatinine kinase (CK) levels which do not resolve with only statin discontinuation. Diagnosis should be made with biopsy and 3-hydroxy-3-methylglutaryl-coenzyme A reductase (HMGCR) antibody detection. The investigation should also be directed to rule out other etiology of proximal myopathy. In most cases, rechallenge with a statin is unsuccessful and immunosuppressive treatment is essential.
ISSN:2168-8184
2168-8184
DOI:10.7759/cureus.21613