Refractory rosuvastatin-associated necrotizing autoimmune myopathy: A case report and review of literature

BACKGROUND Statin-associated necrotizing autoimmune myopathy (NAM) is an immune-mediated myopathy characterized by progressive weakness, markedly elevated creatine kinase (CK), and antibodies to 3-hydroxy-3-methylglutaryl-coenzyme A reductase (HMGCR). Unlike toxic statin myopathy, symptoms and CK elevation persist despite statin discontinuation and typically require immunosuppressive therapy. Although many patients improve with corticosteroids and intravenous immunoglobulin (IVIG), severe or ref