JMIR Publications

ABSTRACT

Background:

Statins, which are a class of lipid-lowering agents, are widely used for the management of hyperlipidemia and to reduce the risk of developing cardiovascular diseases. While generally well-tolerated and safe, they are occasionally associated with muscle-related adverse effects, including myopathy, rhabdomyolysis, and myositis. A rare adverse effect of statin therapy is dermatomyostis, an idiopathic inflammatory myopathy characterized clinically by proximal, symmetrical muscle weakness and characteristic cutaneous manifestations. In this study, we report a case of statin-induced dermatomyositis in a previously healthy individual. Case presentation: A 43-year-old Emirati male, with a history of hyperlipidemia and eczema, presented with progressive muscle pain in the upper thighs, associated with fatigue and proximal muscle weakness. His medical history included the use of atorvastatin 20 mg twice to thrice weekly since for 5 months and then discontinued, as elevated creatinine phosphokinase (CPK) levels were noted. His laboratory results showed high CPK level of 6642 U/L, troponin 455 ng/L, total cholesterol 209 mg/dL, triglycerides 221 mg/dL, creatinine 0.53 mg/dL and eGFR 127.5 mL/min/1.73 m2. His electromyography (EMG) showed proximal myopathy with membrane irritability, fibrillations, and positive sharp waves in the deltoid and tibialis anterior. The patient was diagnosed with statin-induced dermatomyositis based on clinical presentation, persistently elevated CPK levels, and EMG findings. Initial management included IV hydration for elevated CPK levels (>700 U/L). Despite that, his symptoms persisted. He was prescribed calcium with Vitamin D3, magnesium oxide 500 mg tablets, zinc 150 mg tablets, and was advised to avoid strenuous exercise and heat exposure and to maintain adequate hydration. The patient continues to require follow-up for symptom management and monitoring of muscle enzyme levels. Conclusion: This report presents the case of a 43-year-old male who developed statin-induced dermatomyositis. It underlines the importance of monitoring patients on statins, especially those presenting with muscle-related complaints, and highlights the need for a multidisciplinary approach to managing such complex cases.