Refractory rosuvastatin-associated necrotizing autoimmune myopathy: A case report and review of literature

Figure 1 Trend of creatine kinase and serum creatinine during hospitalization. Serial measurements demonstrate persistent elevation of creatine kinase (CK) despite discontinuation of rosuvastatin and escalation of immunosuppressive therapy. CK levels initially declined with supportive treatment but remained elevated following initiation of high-dose intravenous corticosteroids (hospital day 10), intravenous immunoglobulin (hospital day 16), and rituximab (hospital day 28), consistent with treatment-refractory necrotizing autoimmune myopathy. Serum creatinine increased early in the hospital course in the setting of rhabdomyolysis-associated acute kidney injury and subsequently improved after initiation of hemodialysis. IVIG: Intravenous immunoglobulin.