What is immune mediated necrotizing myopathy?
Patients present with acute or subacute proximal weakness and myalgia with markedly elevated CK and scattered necrotic muscle fibers with only sparse inflammatory cell infiltration on muscle biopsy.
The myopathy may be secondary to an underlying connective tissue disease (most commonly scleroderma or mixed connective tissue disease) or cancer but most are likely triggered by statin use.
These patients require treatment with immunosuppressive agents.
