High-Intensity Statin With Severe Consequences: A Case of Non-autoimmune Rosuvastatin-Induced Myonecrosis

Statins constitute a cornerstone in the primary and secondary prevention of atherosclerotic cardiovascular disease (ASCVD). The routine use of these lipid-lowering agents may lead to unintentional neglect of their well-known myotoxic properties. We report the case of a 77-year-old female with a two-year history of rosuvastatin use who presented with progressive bilateral upper and lower extremity muscular weakness for one week, which improved upon discontinuation of her long-term statin therapy. The authors aim to draw attention to this potentially underdiagnosed cause of disability. It is imperative that clinicians are able to appreciate the myopathic spectrum of statin therapy, irrespective of the duration of use. Myonecrosis, in particular, can progress to rhabdomyolysis, leading to irreversible renal dysfunction, electrolyte abnormalities, and subsequent cardiac dysrhythmias. Ultimately, statin-induced myopathy may significantly hinder activities of daily living and impair quality of life. It is, however, a reversible condition if diagnosed and appropriately managed early on. Clinicians are encouraged to acquaint themselves with the symptomatology and relevant laboratory values that commonly accompany this acute condition.