title: A case of asymptomatic cytoplasmic body myopathy revealed by sinvastatin.
abstract: There are only a few reports on the effect of statins over diseased muscle and none in cytoplasmic body myopathy. This is a heterogeneous entity that can be asymptomatic until late in life and is characterized by the presence of numerous cytoplasmic bodies in muscle biopsy. A 74-years-old male received statin treatment on two separate occasions, first with sinvastatin and afterwards with rosuvastatin. In both cases, he experienced diffuse myalgia, lower limbs weakness and respiratory fatigue and improved after interruption of each treatment course. Electromyography has shown signs of muscle necrosis, serum creatine kinase (CK) concentration was increased and muscle biopsy revealed numerous cytoplasmic bodies. To our knowledge this is the first report of statin-related muscle necrosis in a patient with CBM. According to the literature neuropathological features of statin myopathy do not include the presence of cytoplasmic bodies so we assume that cytoplasmic body myopathy was asymptomatically present before statin treatment. This case supports the role of muscle biopsy in patients that develop muscular necrosis while on statin treatment.
authors.affiliation: Department of Neurology, Hospital de Santa Maria, Lisbon, Portugal. tmevangelista@fm.ul.pt
authors.forename: Teresinha
authors.initials: T
authors.lastname: Evangelista
authors.forename: José
authors.initials: J
authors.lastname: Ferro
authors.forename: Pedro
authors.initials: P
authors.lastname: Pereira
authors.forename: Mamede
authors.initials: M
authors.lastname: de Carvalho
mesh_terms: D000368:Aged; D001706:Biopsy / Q000592:standards; D003402:Creatine Kinase / Q000097:blood; D003593:Cytoplasm / Q000473:pathology; D005464:Fluorobenzenes / Q000009:adverse effects; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000009:adverse effects; D002479:Inclusion Bodies / Q000473:pathology*; D008297:Male; D018908:Muscle Weakness / Q000209:etiology / Q000503:physiopathology; D018482:Muscle, Skeletal / Q000187:drug effects* / Q000473:pathology*; D009135:Muscular Diseases / Q000150:complications / Q000378:metabolism / Q000473:pathology*; D009336:Necrosis / Q000139:chemically induced / Q000473:pathology / Q000503:physiopathology; D010146:Pain / Q000139:chemically induced* / Q000503:physiopathology; D011743:Pyrimidines / Q000009:adverse effects; D012206:Rhabdomyolysis / Q000139:chemically induced / Q000473:pathology / Q000503:physiopathology; D000068718:Rosuvastatin Calcium; D019821:Simvastatin / Q000009:adverse effects*; D013449:Sulfonamides / Q000009:adverse effects
chemical_list: D005464:Fluorobenzenes; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D011743:Pyrimidines; D013449:Sulfonamides; D000068718:Rosuvastatin Calcium; D019821:Simvastatin; D003402:Creatine Kinase