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His CK readings fell over this period and returned to normal levels one week after the cessation of his statin medication (Figure ).
Out of 6 published case reports, only 5 patients were noted to have some degree of recovery and only one patient had a complete recovery upon termination of statin therapy.
We cannot rule out completely the possibility that the worsening of our patient's MG simply reflected a progression of his.Regular monitoring of his respiratory function was also initiated.A serum immunoglobulin assay revealed an IgA level.05 g/L.Please report any questionable activity to Conquer MG at 800.888.6208.Statins (inhibitors of reductase) lower the incidence of cerebrovascular disease and coronary heart disease.A 60-year-old Caucasian man of British origin was admitted to our hospital in September 2007 following acute onset of dysarthria and dysphagia.Following prolonged treatment, his muscle strength improved and he returned to independent living at home four months after his admission to our hospital.The actual incidence of statin-exacerbated myasthenia is unknown, and only a handful of reports of statin-associated myasthenia gravis have ever been described.MJK reviewed the patient's clinical data, performed the literature search, and wrote the initial draft of the manuscript.However, the clinical course of his condition, as well as the statin-induced proximal limb pain and weakness (without bulbar features) he experienced prior to his presentation, raises at the very least the possibility that a component of his initial deterioration was statin-related.Keep in mind internet content is always changing, so this does not represent an endorsement or validation by Conquer Myasthenia Gravis for any group, nor is the list intended to be complete.Our patient remained stable over the next few days with a mild dysarthria and dysphagia (tolerating soft food but no other symptoms or signs were noted.It seems probable, however, that both factors played a significant role in the improvement of his clinical state.JMF, SL and JB reviewed the initial draft and finalized the manuscript.There are many online support services for myasthenia gravis patients and individuals with other chronic diseases.However, it is now recognized that myasthenia gravis is actually more prevalent in middle-aged and older groups than younger age groups.
Statin use has increased dramatically over the last decade, with a four-fold increase from 1996 to 1998.
Our patient was then commenced on treatment with pyridostigmine.
He was also started on simvastatin at that time, but this was stopped following the development of proximal muscle weakness, myalgia, and an elevated creatine kinase (CK) of 2599 (normal: 200 which all resolved upon the termination of this medication.However, given the paucity of reports and the widespread use of statins, the possibility of chance association cannot be excluded still.The authors declare that they have no competing interests.Similarly, we note that his improvement could have reflected the immunosuppressive effects of therapy for his MG rather than the withdrawal of his atorvastatin treatment.Information on this page updated June 2016.We also considered other potential causes of deterioration such as sepsis, steroid-induced worsening of MG, steroid myopathy, and cholinergic crisis, but we considered their development less likely based on clinical grounds.It is thus important not to readily dismiss the condition and that appropriate referrals are made.Although generally well-tolerated, statins may have primary care discontinuation rates of up to 30 due to their side effects such as headache, myalgia, paraesthesia, and abdominal discomfort.Myasthenia gravis is a potentially fatal condition that should be considered in elderly patients with bulbar symptoms.
Following this, our patient showed significant improvement in ptosis, a resolution of diplopia, and improved neck, shoulder, and elbow power.