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Case Reports
. 2020 Oct 21;34(1):185-186.
doi: 10.1080/08998280.2020.1831298.

Statin-induced necrotizing autoimmune myopathy

Syed A Huda  1 , Sanjay Yadava  1 , Sara Kahlown  2 , Muhammad S Farooqi  3 , Stephanie Bryant  4 , Ronald Russo  1
Affiliations
Case Reports

Statin-induced necrotizing autoimmune myopathy

Syed A Huda et al. Proc (Bayl Univ Med Cent). .

Abstract

Statins are the most widely used class of drug in the United States. They lower blood cholesterol levels by inhibiting 3-hydroxy-3-methyl-glutaryl-coenzyme A reductase. Common side effects include myalgias and a mild increase in liver function tests. Statin-induced necrotizing autoimmune myopathy (SINAM) is a very rare side effect that is independent of the type and duration of statin use. Treatment involves high-dose steroids and immunosuppressants such as azathioprine, methotrexate, or mycophenolate mofetil. Nonresponders and patients with severe weakness can be treated with intravenous immunoglobulin or rituximab. We present a case of SINAM that was successfully treated with intravenous immunoglobulin.

Keywords: Immunosuppressants; SINAM; rhabdomyolysis; statin-induced necrotizing autoimmune myopathy; statins.

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Figures

Figure 1.
Figure 1.
(a) Hematoxylin and eosin stain showing necrotic fibers with mononuclear cell inflammatory infiltrate. (b) ATPase 4.6 stain showing no selective fiber atrophy. (c) CD68 stain showing darkly staining macrophages within the necrotic fibers. (d) Major histocompatibility complex increased in occasional fascicles, a feature consistent with inflammatory myopathies.
See this image and copyright information in PMC

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