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[Clinical Picture] Immune-mediated necrotising myopathy linked to statin use

In December, 2013, a 59-year-old man presented to the Neurology Department with progressive pelvic girdle myalgia and proximal weakness so severe that he needed help walking. His myalgia had started in March, 2012, 4 months after starting atorvastatin, and had persisted despite discontinuation of the statin in September, 2013. On examination we noted severe proximal paraparesis. Laboratory tests revealed substantially raised serum creatine kinase concentration (3453 U/L, normal range <171 U/L) but no sign of systemic inflammation.