When herpes zoster is not herpes: A case of statin-induced myopathy complicated by drug allergies

Statins are commonly prescribed to reduce cardiovascular risk, but statin-induced myopathy is a leading cause for therapy discontinuation. This case report discusses a 69-year-old female with multiple comorbidities, including smoldering multiple myeloma, who presented with myalgias and a vesicular r...

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Main Authors: Hira Khalid Kareem, Muhammad Fawad Ashraf, Muhammad Shehryar, Hafsa Fayyaz, Shreyas Patil
Format: Article
Language:English
Published: Elsevier 2025-01-01
Series:IDCases
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Online Access:http://www.sciencedirect.com/science/article/pii/S2214250925000198
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author Hira Khalid Kareem
Muhammad Fawad Ashraf
Muhammad Shehryar
Hafsa Fayyaz
Shreyas Patil
author_facet Hira Khalid Kareem
Muhammad Fawad Ashraf
Muhammad Shehryar
Hafsa Fayyaz
Shreyas Patil
author_sort Hira Khalid Kareem
collection DOAJ
description Statins are commonly prescribed to reduce cardiovascular risk, but statin-induced myopathy is a leading cause for therapy discontinuation. This case report discusses a 69-year-old female with multiple comorbidities, including smoldering multiple myeloma, who presented with myalgias and a vesicular rash initially suspected to be herpes zoster due to her immunocompromised status. Elevated creatine kinase (CK) levels were noted (>9000 U/L) while the patient was on high-dose atorvastatin. Despite initial suspicions of herpes zoster, the rash’s atypical progression led to further evaluation, revealing a more complex picture. The patient had a significant history of drug allergies, complicating the diagnosis, particularly following recent clindamycin treatment for a dental issue. After discontinuing atorvastatin and clindamycin, her CK levels improved, and subsequent testing confirmed the presence of anti-HMG-CoA reductase antibodies, establishing a diagnosis of statin-induced autoimmune necrotizing myopathy. This case underscores the importance of detailed patient histories and the need to consider drug-induced hypersensitivity reactions in immunocompromised individuals. The resolution of symptoms after stopping the offending medications emphasizes the critical role of careful monitoring and diagnosis in managing patients with complex medical backgrounds.
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issn 2214-2509
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spelling doaj-art-9d198ab43a494a4d8061b27a03e4b82b2025-02-12T05:31:05ZengElsevierIDCases2214-25092025-01-0139e02164When herpes zoster is not herpes: A case of statin-induced myopathy complicated by drug allergiesHira Khalid Kareem0Muhammad Fawad Ashraf1Muhammad Shehryar2Hafsa Fayyaz3Shreyas Patil4The Wright Center for Graduate Medical Education in Scranton, PA, USAKing Edward Medical University, Lahore, Pakistan; Corresponding author.Icahn School of Medicine at Mount Sinai, NYC H & H/Queens, USAKing Edward Medical University, Lahore, PakistanThe Wright Center for Graduate Medical Education in Scranton, PA, USAStatins are commonly prescribed to reduce cardiovascular risk, but statin-induced myopathy is a leading cause for therapy discontinuation. This case report discusses a 69-year-old female with multiple comorbidities, including smoldering multiple myeloma, who presented with myalgias and a vesicular rash initially suspected to be herpes zoster due to her immunocompromised status. Elevated creatine kinase (CK) levels were noted (>9000 U/L) while the patient was on high-dose atorvastatin. Despite initial suspicions of herpes zoster, the rash’s atypical progression led to further evaluation, revealing a more complex picture. The patient had a significant history of drug allergies, complicating the diagnosis, particularly following recent clindamycin treatment for a dental issue. After discontinuing atorvastatin and clindamycin, her CK levels improved, and subsequent testing confirmed the presence of anti-HMG-CoA reductase antibodies, establishing a diagnosis of statin-induced autoimmune necrotizing myopathy. This case underscores the importance of detailed patient histories and the need to consider drug-induced hypersensitivity reactions in immunocompromised individuals. The resolution of symptoms after stopping the offending medications emphasizes the critical role of careful monitoring and diagnosis in managing patients with complex medical backgrounds.http://www.sciencedirect.com/science/article/pii/S2214250925000198Statin-induced myopathyDrug alleryHerpes zosterImmunocompromised
spellingShingle Hira Khalid Kareem
Muhammad Fawad Ashraf
Muhammad Shehryar
Hafsa Fayyaz
Shreyas Patil
When herpes zoster is not herpes: A case of statin-induced myopathy complicated by drug allergies
IDCases
Statin-induced myopathy
Drug allery
Herpes zoster
Immunocompromised
title When herpes zoster is not herpes: A case of statin-induced myopathy complicated by drug allergies
title_full When herpes zoster is not herpes: A case of statin-induced myopathy complicated by drug allergies
title_fullStr When herpes zoster is not herpes: A case of statin-induced myopathy complicated by drug allergies
title_full_unstemmed When herpes zoster is not herpes: A case of statin-induced myopathy complicated by drug allergies
title_short When herpes zoster is not herpes: A case of statin-induced myopathy complicated by drug allergies
title_sort when herpes zoster is not herpes a case of statin induced myopathy complicated by drug allergies
topic Statin-induced myopathy
Drug allery
Herpes zoster
Immunocompromised
url http://www.sciencedirect.com/science/article/pii/S2214250925000198
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