73 results
Statin Induced Muscle Toxicity - Summary

Clinical Presentation:
 • Elevations of serum creatine kinase with proximal myalgia
• Inflammatory myopathy ... hypothyroid-induced myopathy ... Statin-induced myopathy ... - Necrotizing myopathy ... fibers Risk of myopathy
Myositis and Myopathies
Polymyositis 
 • Progressive, symmetric muscle weakness 
 • Elevated CK, +Anti-Jo, +Anti-Mi2
Dermatomyositis
rimmed vacuoles HIV myopathy ... load Drug-induced myopathy ... Gemcitabine Lupus Myopathy ... 5-15% of lupus myopathy ... Myositis #Myopathies #myopathy
Causes of Proximal Muscle Weakness That May Mimic Inflammatory Myopathy
 • Central or peripheral neurologic disease
Mimic Inflammatory Myopathy ... Mitochondrial myopathy ... MuscleWeakness #Myopathy
Idiopathic Inflammatory Myopathies - 
Dermatomyositis (DM), Immune-Mediated Necrotizing Myopathy (IMNM), Antisynthetase Syndrome (ASS), Inclusion Body Myositis
Immune-Mediated Necrotizing Myopathy ... Myopathies #Idiopathic #Myopathy
Hypothyroid Myopathy
Very common (up to 80% ) in patients with hypothyroidism
Pathophysiology:
 • T4 deficiency leads to
Hypothyroid Myopathy ... Symmetric, proximal myopathy ... #Hypothyroid #Myopathy
Bilateral Foot Drop secondary to Nonaka Myopathy

48 yr old lady, difficulty in climbing stairs x 8
secondary to Nonaka Myopathy ... recessive Nonaka myopathy ... GNE myopathy, also ... as HIBM, Nonaka myopathy ... IBM2 and distal myopathy
Idiopathic Inflammatory Myopathies (IIM's)

RASH + MUSCLE WEAKNESS → Consider idiopathic inflammatory myopathies (IIM's)

 • Overlap Myositis
Any inflammatory myopathy ... Inflammatory myopathy ... #dermatology #Myopathy
Autoimmune Myositis - Differential Diagnosis Framework

Inflammatory Myopathies: Commonly symmetric proximal muscle weakness, no substantial muscle pain
NECROTIZING AUTOIMMUNE MYOPATHY ... syndrome • If myopathy ... ANTI-MITOCHONDRIAL MYOPATHY ... Autoimmune #Myositis #Myopathy
Myositis and Myopathies
#ESR #CK #Differential diagnosis of myopathy 
#Inflammatory #myopathies	#Dermatomyositis	
#muscle weakness
#Polymyositis	
#Inclusion body myositis
#Polymyalgia rheumatica	
#Fibromyalgia	
#Hypothyroid myopathy	
#Muscle stiffness
#Drug-induced
Differential diagnosis of myopathy ... #Hypothyroid myopathy ... Corticosteroid-induced myopathy ... Statin-induced myopathy ... Cocaine-induced myopathy
Neurological Patterns of Weakness
 • Hemispheric lesion
 • Brainstem lesion
 • Spinal cord lesion
 • Polyneuropathy
Polyneuropathy • Myopathy