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Toxic Myopathy & Inflammatory Myositis

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A Case of Atorvastatin Combined Toxic Myopathy and Inflammatory Myositis

   

Darcy Folzenlogen

Assistant Professor of Medicine

University of Missouri Health Care

Department of Internal Medicine

Division of Rheumatology

Columbia, Missouri

JCR: JOURNAL OF CLINICAL RHEUMATOLOGY 2001;7:340-345

Muscle toxicity is one adverse reaction reported with the use of

3-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase inhibitors

(statins).

This toxicity may include asymptomatic elevations of muscle enzymes,

weakness, myalgia, and myositis. High doses of statins, or the

combination of statins with other anticholesterol medications, increase

the risk of toxicity. In addition, case reports of systemic and

autoimmune reactions such as lupus, nephritis, vasculitis, and myositis,

suspected to be associated with statins, have been reported.

Our 76-year-old patient demonstrates a case of serologically and

biopsy-proven inflammatory polymyositis, combined with a statin toxic

myopathy. His symptoms and enzyme abnormalities resolved with both the

removal of the statin medication and the institution of

immunosuppressive therapy. Investigation of muscle enzyme elevation and

weakness that do not resolve with statin removal is warranted.

Certain muscle biopsy findings, including mononuclear cell infiltrate,

distinguish the etiology asinflammatory/possibly autoimmune and do not

suggest statin myopathy.

Key words: HMG-CoA reductase inhibitors; Myopathy; Myositis; Statins

~ Vicki ~

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