McArdle's disease diagnosed following statin-induced myositis.
We describe the case of a 69-year-old man with a history of muscular symptoms dating back to his childhood; McArdle's disease (glycogen-storage disease V) was diagnosed following an episode of myositis in which a statin and physical exertion appear to have been precipitating factors. This case demonstrates that the ischaemic lactate-ammonia test still has a place in screening patients with symptoms suggestive of McArdle's disease and emphasizes the importance of carrying out glycogen phosphorylase histochemistry on the skeletal muscle biopsy to confirm the diagnosis. In patients who develop a raised plasma creatine kinase level or muscular symptoms during lipid-lowering therapy, the clinician should be alert to the possibility of an underlying myopathy.
Department of Clinical Biochemistry, Royal Surrey County Hospital, Guildford GU2 7XX, UK. clivingstone@royalsurrey.nhs.uk
Callum
C
Livingstone
Said
S
Al Riyami
Peter
P
Wilkins
Gordon A A
GA
Ferns
D000368:Aged; D000641:Ammonia / Q000097:blood; D000924:Anticholesteremic Agents / Q000009:adverse effects; D003402:Creatine Kinase / Q000097:blood; D006012:Glycogen Storage Disease Type V / Q000175:diagnosis* / Q000378:metabolism; D006801:Humans; D019344:Lactic Acid / Q000097:blood; D008297:Male; D018482:Muscle, Skeletal / Q000378:metabolism; D009220:Myositis / Q000139:chemically induced* / Q000378:metabolism; D005082:Physical Exertion; D019821:Simvastatin / Q000009:adverse effects*
D000924:Anticholesteremic Agents; D019344:Lactic Acid; D000641:Ammonia; D019821:Simvastatin; D003402:Creatine Kinase