Statin-Associated Necrotizing Autoimmune Myositis Complicated by an Uncommon Adverse Effect to Treatment.

摘要: Statin-associated necrotizing autoimmune myositis (NAM) is an condition characterized by severe acute-onset proximal muscle weakness, a very high creatinine kinase (CK) level, and prominent myofiber necrosis minimal lymphocytic infiltration on biopsy. Unlike self-limited statin myopathy, this usually requires aggressive immunomodulation therapy to assist recovery prevent future disability. In case report, we present patient who developed progressive weakness after taking atorvastatin for one year. At initial presentation, her CK level was 28,000 U/L. She diagnosed with statin-associated NAM started high-dose intravenous solumedrol, mycophenolate, immunoglobulin (IVIG) therapy. However, she subsequently acute bilateral vision loss right side hemineglect; posterior reversible encephalopathy syndrome (PRES), thought be possible delayed adverse reaction IVIG. IVIG discontinued, the treated supportive six-month follow-up, had significant improvement in strength vision.