Lavina Jethani* and Ernesto Cruz
Department of Physical Medicine and Rehabilitation, Temple University, USAFulltext PDF
An 85-year-old male with hypertension and hyperlipidemia, who was previously independent, was started on simvastatin for treatment of hyperlipidemia in January 2018. In March 2018, he developed weakness and declined in function. He had decreased exercise tolerance, increased fatigue, deconditioning, and ambulatory and ADL dysfunction, and saw his primary care doctor in May 2018, at which time he was admitted to the hospital with concerns of adult-onset muscular dystrophy. He diagnosed with rhabdomyolysis and elevated liver enzymes and was treated with intravenous fluids. Over the next three months, the patient’s symptoms and elevated CK persisted. He was admitted to the hospital twice more and had multiple clinic appointments before immunemediated necrotizing myositis due to statin was suspected and ultimately diagnosed with left bicep biopsy. Patient was admitted a final time for treatment with prednisone and IVIG. His symptoms progressively improved, and he was able to ambulate over 150 feet after 5 doses of IVIG. This patient suffered a prolonged period of debility due to the delay in diagnosis and treatment. This case demonstrates the importance of continuing the diagnostic evaluation when the current diagnosis does not fully explain the symptoms and when symptoms do not improve with treatment.
Statin; Myositis; Immune-mediated; Necrotizing
Jethani L, Cruz E. When Rehabilitation is not the Answer: A Case Report of Statin Use. Ann Clin Case Rep. 2019; 4: 1637.