Rheumatologist extraordinaire Mike George was kind enough to help us through a case of a middle-aged woman with weakness who was ultimately diagnosed with a necrotizing myopathy due to HMG CoA reductase antibodies. Along the way we learned how to approach a patient with weakness:
Take home pearls:
- Use a neuroanatomic approach to a patient with weakness
- Perform a good neuro exam (including reflexes) on any patient with weakness
- Endocrine and toxic/drug myopathies are the most common of any kind of myopathy (including inflammatory myopathies)
- Chawla J. Stepwise Approach to Myopathy in Systemic Disease. Frontiers in Neurology 2011.
- Mammen, A. 2016. Statin-Associated Autoimmune Myopathy. The New England Journal of Medicine. 374, 7 (2016), 664–669.