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[Subacute Flaccid Tetraparesis].

Lisa Hunziker¹, Jan Dracklé¹

¹Klinik für Innere Medizin, Kantonsspital Winterthur, Winterthur Schweiz.

|April 27, 2022

Summary

A patient with statin-associated immune-mediated necrotizing myopathy experienced significant recovery after treatment with high-dose immunoglobulins (Privigen®). This treatment resolved symptoms and improved daily functioning, offering a new therapeutic avenue.

Keywords:

Creatine kinase Kreatinkinase Statin bilateral muscle weakness immun-mediierte nekrotisierende Myopathie immune-mediated necrotizing myopathy proximale schlaffe Parese statin

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Area of Science:

Neurology
Immunology
Pharmacology

Background:

Statin-associated immune-mediated necrotizing myopathy presents as subacute flaccid tetraparesis.
Standard treatments including neurorehabilitation, prednisolone, and azathioprine may not achieve remission.

Purpose of the Study:

To report a case of statin-associated immune-mediated necrotizing myopathy successfully treated with high-dose immunoglobulins.

Main Methods:

Clinical examination, laboratory analysis, electromyography (EMG), magnetic resonance imaging (MRI), and muscle biopsy were used for diagnosis.
The patient underwent neurorehabilitation, prednisolone, azathioprine, and subsequently, two cycles of high-dose immunoglobulins (Privigen®).

Main Results:

Diagnosis confirmed as statin-associated immune-mediated necrotizing myopathy.
Initial therapies did not induce remission.
Two cycles of Privigen® led to near-complete symptom resolution and functional recovery.
Creatine kinase (CK) levels decreased to 400 U/l.

Conclusions:

High-dose immunoglobulins (Privigen®) can be an effective treatment for refractory statin-associated immune-mediated necrotizing myopathy.
This therapeutic approach offers a promising option for patients unresponsive to conventional treatments.