Statin-Induced Necrotizing Autoimmune Myopathy in a Patient With Complex Diabetes Management

Patients presenting with proximal muscle weakness and elevated CPK, even after statin discontinuation, should be considered for a full workup for potential SINAM. The detection of anti-HMGCR antibodies or presence of necrosis on muscle biopsy are necessary for a formal diagnosis. This case displayed success with IVIG monotherapy, although previous research suggests the best chance of muscle symptom improvement is with a combination of a glucocorticoid, methotrexate, and IVIG.