PMC9880591_01
Time in months versus creatinine kinase. This graph represents the patients
CK level (muscle enzyme, correlated with severity of myopathy) over time in
months. The graph plots the values of the CK while on atorvastatin,
rosuvastatin, and while off all statins (green line) over time.
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Almost 6 months after the discontinuation of atorvastatin, he was placed on a trial of rosuvastatin but this also led to a gradual increase in his CK that peaked at a level of 3393 U/L (Figure 1).
Pathology results of the left anterior thigh muscle biopsy: (a) This is an
H&E stain of a degenerating muscle fiber. The arrow points to
degenerating myofiber. Stars indicate increased internal nuclei which is a
nonspecific myopathic feature. There are also myofibers of various sizes and
shapes; this is also a nonspecific myopathic feature, (b) CD68 showing it is
degenerating by macrophages. CD3 stains there are minimal. T-lymphocytes and
those present are associated with degenerating fibers or in endomysial
space. There are no T-cells invading viable myofibers. Skeletal muscle with
myopathic features including myofiber degeneration and regeneration. This
skeletal muscle biopsy reveals myopathic features with evidence of scattered
myofiber degeneration and regeneration and foci of endomysial macrophage
infiltration associated with areas of myofiber necrosis.
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