Necrotizing autoimmune myopathy: Muscle weakness due to atorvastatin

Statins are medications with great use. One of the side effects of medications is myopathy. In some case, statins switch on, a process of autoimmune system which will not terminate with discontinuation of statins. Necrotizing autoimmune myopathy (NAM) is a subgroup of inflammatory myopathies characterized pathologically by necrotic muscle fibers with absent or minimal inflammation. The purpose of this study was to describe NAM in a patient undergoing treatment with atorvastatin for an extended period, diagnosis of the disease process, treatment, and resolution of symptoms. The case presented in this paper is about 72-year-old woman who showed continued general weakness even though she stopped taking atorvastatin. This patient also had elevated creatine kinase and aldolase. Myopathy confirmed by muscle biopsy. She was treated with intravenous immune globulin (IVIG) and pulse of methyl prednisolone and followed with high dose of steroid and azathioprine. Our case report illustrates the importance of early recognition of NAM and that the treatment with immediately administer IVIG, pulse of methylprednisolone, and high dose of steroid can result in complete recovery.