SHM Converge Scientific Abstract ePoster Gallery-Statin Induced Necrotizing Myopathy With Rhabdomyolysis and Acute Renal Failure

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A 71-year-old woman with type 2 diabetes, hypertension, and chronic kidney disease presented with progressive weakness, body aches, and inability to walk. She was taking insulin, valsartan, and rosuvastatin. In the emergency department, she was found to have severe acute kidney injury, with creatinine rising to 7.99 mg/dL from a baseline of about 2 mg/dL, and markedly elevated creatine kinase (CK) of 20,000 U/L, consistent with rhabdomyolysis. She was started on dialysis due to renal failure.<br /><br />Because of concern for inflammatory myopathy, she was initially treated with prednisone. A muscle biopsy showed changes most consistent with statin-induced necrotizing myopathy and rhabdomyolysis, and MRI of the thighs demonstrated diffuse muscle and fascial edema consistent with myositis. An extensive myositis workup, including anti-HMG-CoA reductase antibodies, was negative. After the biopsy results, prednisone was stopped and rosuvastatin was discontinued.<br /><br />During hospitalization, she continued dialysis and was followed closely by nephrology as an outpatient. Her CK levels gradually decreased, her weakness improved, and she eventually regained independent ambulation. At three months, her renal function had improved enough that dialysis was discontinued.<br /><br />The discussion emphasizes that statin-associated muscle symptoms range from mild myalgias to rhabdomyolysis and immune-mediated necrotizing myopathy. Rhabdomyolysis is a rare but serious complication that can cause acute renal failure, especially in older patients and those with kidney dysfunction. The key management is immediate statin discontinuation, with dialysis considered in severe cases. Patients who have had statin-induced rhabdomyolysis should generally avoid future statin therapy because of recurrence risk.

Asset Subtitle

Shenjun Zhu

Meta Tag

Author List Pinar Arikan, Shenjun Zhu

Category Clinical Vignettes

Concept Statin Therapy

Concept Statin-Associated Muscle Symptoms

Concept Rhabdomyolysis

Concept Immune-Mediated Necrotizing Myopathy

Concept Acute Kidney Injury

Distinguished Non-Finalist

Presenter Organization The Miriam Hospital

Presenting Author Shenjun Zhu

Track Adult

Keywords

statin-induced rhabdomyolysis

acute kidney injury

creatine kinase elevation

rosuvastatin

necrotizing myopathy

dialysis

myositis

muscle biopsy

chronic kidney disease

statin discontinuation

Statin Therapy

Statin-Associated Muscle Symptoms

Rhabdomyolysis

Immune-Mediated Necrotizing Myopathy

Acute Kidney Injury