Atorvastatin
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Atorvastatin Non-immune mediated necrotising myopathy: case report
An approximately 57-year-old man developed non-immune mediated necrotising myopathy during treatment with atorvastatin. The man, who had been receiving chronic atorvastatin [dosage, route and indication not stated], presented with progressive muscle weakness (at the age 58 years). His symptoms started 1 year prior to the presentation noted first at lower extremities with difficulty climbing stairs and standing from sitting position. Later on, it progressed to his upper extremities with diffuse muscle pain. His weakness progressed to more severe and diffuse with worsening pain, leading to hospitalisation to inpatient due to severe weakness. The man’s therapy with atorvastatin was discontinued. He was then presented at an outpatient clinic 2 months later. His examination revealed proximal upper and lower extremity weakness including mild facial involvement and neck flexion weakness with sensory sparing and normal reflexes. Laboratory investigation showed creatine kinase (CK) at 10,000 range during hospitalisation, and currently at 3000. An electromyogram revealed irritable myopathic changes. Muscle biopsy revealed myopathic changes with necrotic muscle fibers and no lymphocytic infiltration. Based on the finding, he was diagnosed with non-immune mediated necrotising myopathy secondary to atorvastatin [time to reaction onset not stated]. Subsequently, he achieved gradual improvement over time. He was back to baseline following a year from withdrawal of atorvastatin. Hussain Y, et al. Other Myopathies. Neurologic Clinics 38: 619-635, No. 3, Aug 2020. Available from: URL: http://doi.org/10.1016/j.ncl.2020.04.002
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Reactions 22 Aug 2020 No. 1818
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