Statin--induced necrotizing autoimmune myopathy as an unusual cause of extreme elevation of cardiac markers in a patient with muscle weakness and swelling
Authors:
J. Švarko 1; E. Lokočová 2; E. Kourková 3; P. Zajíček 1
Authors‘ workplace:
Interní oddělení Nemocnice Valašské Meziříčí
1; Fakultní nemocnice Olomouc, III. interní klinika – nefrologická, revmatologická a endokrinologická
2; Hematologicko-transfuzní oddělení Vsetínské nemocnice
3
Published in:
Čes. Revmatol., 28, 2020, No. 1, p. 52-60.
Category:
Case Report
Overview
This review article with a case report shows a patient admitted to our department for a newly developed proximal weakness of the limbs and swelling. Laboratory examination showed an enormous elevation of cardiac markers – creatine kinase (CK-MB), troponins (hs-cTnT) and myoglobin. Statin medication had been chronically used. The cardiac cause of the laboratory findings was considered very unlikely due to the examinations performed. The polymyositis was considered another potential cause, but we initially refused it on the basis of negative findings of autoantibodies. Examinations that were gradually completed resulted in a final diagnosis of Statin-Induced Necrotizing Autoimmune Myopathy (SINAM) with a positive antibody to 3-hydroxy-3-methyl- glutaryl coenzyme A reductase (anti-HMGCR). Three months after the initiation of the immunosuppressive therapy, the range of motion of the extremities was significantly improved and swelling was reduced.
Keywords:
statins – limb-girdle weakness – swelling – immune-mediated necrotizing myopathy – anti-HMGCR
Sources
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Labels
Dermatology & STDs Paediatric rheumatology RheumatologyArticle was published in
Czech Rheumatology
2020 Issue 1
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