Weakness Due to Anemia? Go Fish! Melena as a Red Herring in the Diagnosis of Statin-Induced Myopathy.
medical error
myopathy
statin
weakness
Journal
Cureus
ISSN: 2168-8184
Titre abrégé: Cureus
Pays: United States
ID NLM: 101596737
Informations de publication
Date de publication:
29 Sep 2020
29 Sep 2020
Historique:
entrez:
4
11
2020
pubmed:
5
11
2020
medline:
5
11
2020
Statut:
epublish
Résumé
Statins are a ubiquitous medication class in the primary care setting where they provide effective primary and secondary prevention of coronary artery disease by lowering cholesterol. While statins are mostly safe, muscle-related adverse events are well described. Very rarely patients can actually develop elevated creatine kinase (CK) consistent with myonecrosis. We present a case of progressive anti-hydroxymethylglutaryl coenzyme A reductase (anti-HMGCR) inflammatory myopathy, which was misdiagnosed for many months. Our patient was a 67-year-old gentleman sent to the ER by the Internal Medicine Clinic for profound weakness and melena. He had recently undergone esophagogastroduodenoscopy (EGD) for evaluation of progressive dysphagia and was found to be significantly anemic. Repeat EGD demonstrated a bleeding ulcer, and his weakness was attributed to anemia; however, careful examination demonstrated objective muscle weakness which could not be attributed to anemia alone. Subsequent work-up demonstrated myositis due to HMGCR antibody. Statin cessation and treatment with steroids and intravenous immunoglobulin (IVIG) led to a nearly full recovery in strength and resolution of dysphagia over the next several months.
Identifiants
pubmed: 33145125
doi: 10.7759/cureus.10717
pmc: PMC7598209
doi:
Types de publication
Case Reports
Langues
eng
Pagination
e10717Informations de copyright
Copyright © 2020, Revere et al.
Déclaration de conflit d'intérêts
The authors have declared that no competing interests exist.
Références
BMJ. 2016 May 03;353:i2139
pubmed: 27143499
Pharmacol Res. 2014 Oct;88:3-11
pubmed: 24657242
J Clin Rheumatol. 2017 Apr;23(3):149-154
pubmed: 28277343
Case Rep Med. 2019 Jun 25;2019:4601304
pubmed: 31341481
Med Teach. 2008 Jun;30(5):496-500
pubmed: 18576188
J Neuromuscul Dis. 2018;5(2):109-129
pubmed: 29865091
Curr Opin Lipidol. 2017 Apr;28(2):186-192
pubmed: 28207435
Expert Rev Clin Immunol. 2018 Mar;14(3):215-224
pubmed: 29473763
J Hosp Med. 2018 Mar 26;13(8):570-572
pubmed: 29578553
Pharmacy (Basel). 2018 May 14;6(2):
pubmed: 29757930
Arthritis Res Ther. 2020 Jan 8;22(1):5
pubmed: 31915059
Physiol Res. 2014;63(Suppl 3):S327-34
pubmed: 25428737
Rheumatology (Oxford). 2017 May 1;56(5):787-794
pubmed: 28096458
Heart Views. 2011 Jul;12(3):121-7
pubmed: 22567201