Statin-Associated Immune-Mediated Necrotizing Myopathy: A Case Report

Statins are a widely used class of drugs that have been found to be safe and effective in treating hypercholesterolemia. Statin-associated muscle symptoms (SAMS) are a clinical spectrum defined as muscle pain, discomfort, and/or weakness with or without elevated CK levels. This spectrum ranges from more common minimal myalgias to rare, severe statin-associated immune-mediated necrotizing myopathy (IMNM). Diagnosis of IMNM can be difficult, as there is a gradual onset of vague symptoms presenting years after statin initiation. It is known that early intervention with medical therapies including IVIG and IV steroids are vital to preserving and improving muscle function, so swift diagnosis is key for maximal patient recovery. IMNM is a rare complication of statin use but should be considered in all statin users presenting with proximal weakness affecting functioning regardless of statin onset time. Treating this diagnosis requires a multi-disciplinary approach to facilitate restoring function and quality of life. This case report discusses a rare case of statin-associated IMNM.