PMC6188590_01
CPK levels during statin therapy, before presenting to Rheumatology Clinic.
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While she was on therapy with atorvastatin, baseline CPK levels were in the 230 mg/dl, with the highest value being 529 mg/dl at the time of therapy discontinuation (Figure 1).
CPK levels after statin re-challenge and initiation of immunosuppressive therapy.
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CPK levels increased again to 586 mg/dl, and the sedimentation rate (ESR) was 51 mm/hr (Figure 2).
Muscle intrafascicular and perivascular lymphocytic inflammation (H&E, photomicrograph x100).
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The pathology report was consistent with inflammatory necrotizing myopathy (intrafascicular inflammation with muscle atrophy, the inflammation is predominantly intrafascicular with actively necrotic muscle fibers) (Figures 3 and 4).
Lymphocytic inflammation surrounding muscle fibers (H&E, photomicrograph x400).
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The pathology report was consistent with inflammatory necrotizing myopathy (intrafascicular inflammation with muscle atrophy, the inflammation is predominantly intrafascicular with actively necrotic muscle fibers) (Figures 3 and 4).