{"title":"Statin-induced immune mediated necrotising myopathy presenting with a markedly elevated cardiac troponin T in the absence of myocardial injury.","authors":"David Hall, Goodness Mbonu, Zulakha Nadeem","doi":"10.1093/omcr/omae190","DOIUrl":null,"url":null,"abstract":"<p><p>Cardiac troponin (cTn) is a sensitive test to assess for myocardial injury. However certain clinical situations can result in a raised cTn in the absence of cardiac involvement. Here we present a case of a 65-year-old woman on long term atorvastatin who presented with generalised weakness, non-specific chest pain, and a persistently elevated high sensitivity cardiac troponin T. Upon further investigation acute myocardial injury was excluded and a diagnosis of statin-induced immune mediated necrotising myopathy (IMNM) was made. The patient improved with cessation of atorvastatin and initiation of immunosuppressive therapy with mycophenolate, intravenous immunoglobulin, and steroids. The mechanism for cTn elevation in skeletal myopathies without cardiac damage and the presentation and treatment of statin-induced IMNM are reviewed. We highlight the importance that in these cases the true cause of the raised cTn is recognised to allow prompt diagnosis and treatment of the underlying myopathy.</p>","PeriodicalId":45318,"journal":{"name":"Oxford Medical Case Reports","volume":"2025 2","pages":"omae190"},"PeriodicalIF":0.5000,"publicationDate":"2025-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11845343/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Oxford Medical Case Reports","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1093/omcr/omae190","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/2/1 0:00:00","PubModel":"eCollection","JCR":"Q3","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
引用次数: 0
Abstract
Cardiac troponin (cTn) is a sensitive test to assess for myocardial injury. However certain clinical situations can result in a raised cTn in the absence of cardiac involvement. Here we present a case of a 65-year-old woman on long term atorvastatin who presented with generalised weakness, non-specific chest pain, and a persistently elevated high sensitivity cardiac troponin T. Upon further investigation acute myocardial injury was excluded and a diagnosis of statin-induced immune mediated necrotising myopathy (IMNM) was made. The patient improved with cessation of atorvastatin and initiation of immunosuppressive therapy with mycophenolate, intravenous immunoglobulin, and steroids. The mechanism for cTn elevation in skeletal myopathies without cardiac damage and the presentation and treatment of statin-induced IMNM are reviewed. We highlight the importance that in these cases the true cause of the raised cTn is recognised to allow prompt diagnosis and treatment of the underlying myopathy.
期刊介绍:
Oxford Medical Case Reports (OMCR) is an open access, peer-reviewed online journal publishing original and educationally valuable case reports that expand the field of medicine. The journal covers all medical specialities including cardiology, rheumatology, nephrology, oncology, neurology, and reproduction, comprising a comprehensive resource for physicians in all fields and at all stages of training. Oxford Medical Case Reports deposits all articles in PubMed Central (PMC). Physicians and researchers can find your work through PubMed , helping you reach the widest possible audience. The journal is also indexed in the Web of Science Core Collection . Oxford Medical Case Reports publishes case reports under the following categories: Allergy Audiovestibular medicine Cardiology and cardiovascular systems Critical care medicine Dermatology Emergency medicine Endocrinology and metabolism Gastroenterology and hepatology Geriatrics and gerontology Haematology Immunology Infectious diseases and tropical medicine Medical disorders in pregnancy Medical ophthalmology Nephrology Neurology Oncology Paediatrics Pain Palliative medicine Pharmacology and pharmacy Psychiatry Radiology, nuclear medicine, and medical imaging Respiratory disorders Rheumatology Sexual and reproductive health Sports Medicine Substance abuse.