Necrotizing Autoimmune Myopathy: A Case Report on Statin-Induced Rhabdomyolysis

Abstract

Statin-induced necrotizing myopathy (SINM) is an uncommon but severe complication associated with statin medication. SINM can develop at any point after a person starts taking steroids. It is now being acknowledged as a component of the broader category of "statin-induced myopathy." Like other immunemediated necrotizing muscle diseases, statin-induced myositis is identified by weakness in proximal muscles, increased serum creatine kinase (CK) levels, and, in some cases, dysphagia and respiratory distress. In addition, there is evidence of muscle cell damage when examined under a microscope, occurring with minimal or no infiltration of inflammatory cells. Diagnosing SINM promptly is frequently challenging due to its unpredictable development over time, with symptoms sometimes emerging many years after the initial exposure to statins. One distinctive characteristic of SINM is the continued presence of muscle inflammation and elevated CK levels even after discontinuing statin treatment. Currently, no clinical trials are available to guide how to manage statin-induced immune-mediated necrotizing myopathy (IMNM). Here, we present a case of a 42-year-old woman diagnosed with SINM and was found to have persistently elevated CPK despite discontinuation of statins. Our case also suggests that intravenous (IV) immunoglobins and steroids are an effective and well-tolerated alternative to immunosuppressants.

Crushing Muscles: A Case Study on Rhabdomyolysis, Renal Failure, and Compartment Syndrome Triggered by Pre-Workout Supplement Abuse

“…Managing rhabdomyolysis requires evaluating and removing the potential causes, as well as immediate and aggressive hydration and correction of electrolyte and acid-base abnormalities [35]. In selected cases, preventing additional complications using sodium bicarbonate can help prevent myoglobin breakdown into the nephrotoxic metabolite called ferrihemate [36][37][38]. The overall prognosis of rhabdomyolysis is excellent when treated early, and most of the individuals have complete recovery of renal function, with approximately 4% requiring hemodialysis [39][40][41].…”