Statin-Induced Necrotizing Autoimmune Myositis (SINAM)- Rare Chronic Progressive Disease in an Elderly- First Reported Case in Bahrain

Statins are commonly used for controlling lipid profile; however, it has spectrum of side effects that ranged from very mild myalgia to a serious fatal necrotizing myositis. An entity known as statin induce necrotizing autoimmune myositis (SINAM) is characterized by proximal muscle weakness and elevated creatinine kinase. If not treated, it can lead to rhabdomyolysis, thus managing it in early stages is crucial. Nevertheless, steroids remain the milestone of treatment. In this study, we describe a case of 74-year-old patient who was on daily statin and developed right thigh pain and bilateral progressive proximal lower limb weakness for several months until the point where he became almost bedridden. Labs of this patient showed high CK level and positive HMG-CoA enzyme, his MRI showed show abnormal high T2 signal intensity of pelvic muscles with reduced muscle bulk and fatty infiltration. Statin was discontinued and patient received steroieds and IVIG and was monitored until discharge. Key words: Statins, Myopathy, necrotizing autoimmune myositis, vasculitis, rhabdomyolysis