{"id":"https://openalex.org/W7127042576","doi":"https://doi.org/10.7759/cureus.102783","title":"Statin-Induced Necrotizing Autoimmune Myositis Presenting With Progressive Limb-Girdle Weakness Following Low-Dose Atorvastatin Use","display_name":"Statin-Induced Necrotizing Autoimmune Myositis Presenting With Progressive Limb-Girdle Weakness Following Low-Dose Atorvastatin Use","publication_year":2026,"publication_date":"2026-02-01","ids":{"openalex":"https://openalex.org/W7127042576","doi":"https://doi.org/10.7759/cureus.102783","pmid":"https://pubmed.ncbi.nlm.nih.gov/41783877"},"language":"en","primary_location":{"id":"doi:10.7759/cureus.102783","doi":"https://doi.org/10.7759/cureus.102783","is_oa":true,"landing_page_url":"https://doi.org/10.7759/cureus.102783","pdf_url":"https://www.cureus.com/articles/447959-statin-induced-necrotizing-autoimmune-myositis-presenting-with-progressive-limb-girdle-weakness-following-low-dose-atorvastatin-use.pdf","source":{"id":"https://openalex.org/S2738950867","display_name":"Cureus","issn_l":"2168-8184","issn":["2168-8184"],"is_oa":true,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core"],"host_organization":"https://openalex.org/P4310316779","host_organization_name":"Cureus, Inc.","host_organization_lineage":["https://openalex.org/P4310316779"],"host_organization_lineage_names":["Cureus, Inc."],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Cureus","raw_type":"journal-article"},"volume":null,"type":"article","indexed_in":["crossref","pubmed"],"open_access":{"is_oa":true,"oa_status":"diamond","oa_url":"https://www.cureus.com/articles/447959-statin-induced-necrotizing-autoimmune-myositis-presenting-with-progressive-limb-girdle-weakness-following-low-dose-atorvastatin-use.pdf","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5124706919","display_name":"Layla Annous","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I1281704429","display_name":"Christiana Care Health System","ror":"https://ror.org/02h905004","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I1281704429"]},{"id":"https://openalex.org/I4210105554","display_name":"Christiana Hospital","ror":"https://ror.org/01gxs7p86","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I1281704429","https://openalex.org/I4210105554"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Layla Annous","raw_affiliation_strings":["Internal Medicine - Pediatrics, Christiana Care Health System, Newark, USA"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Internal Medicine - Pediatrics, Christiana Care Health System, Newark, USA","institution_ids":["https://openalex.org/I1281704429","https://openalex.org/I4210105554"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5124695024","display_name":"Osama Mahmoud","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I1281704429","display_name":"Christiana Care Health System","ror":"https://ror.org/02h905004","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I1281704429"]},{"id":"https://openalex.org/I4210105554","display_name":"Christiana Hospital","ror":"https://ror.org/01gxs7p86","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I1281704429","https://openalex.org/I4210105554"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Osama Mahmoud","raw_affiliation_strings":["Internal Medicine, Christiana Care Health System, Newark, USA"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Internal Medicine, Christiana Care Health System, Newark, USA","institution_ids":["https://openalex.org/I1281704429","https://openalex.org/I4210105554"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":2,"corresponding_author_ids":[],"corresponding_institution_ids":[],"apc_list":null,"apc_paid":null,"fwci":4.4714,"has_fulltext":true,"cited_by_count":1,"citation_normalized_percentile":{"value":0.89975458,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":{"min":93,"max":96},"biblio":{"volume":"18","issue":"2","first_page":"e102783","last_page":"e102783"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T11724","display_name":"Inflammatory Myopathies and Dermatomyositis","score":0.9897000193595886,"subfield":{"id":"https://openalex.org/subfields/2713","display_name":"Epidemiology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T11724","display_name":"Inflammatory Myopathies and Dermatomyositis","score":0.9897000193595886,"subfield":{"id":"https://openalex.org/subfields/2713","display_name":"Epidemiology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T11735","display_name":"Peripheral Neuropathies and Disorders","score":0.002300000051036477,"subfield":{"id":"https://openalex.org/subfields/2728","display_name":"Neurology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10697","display_name":"Vasculitis and related conditions","score":0.0013000000035390258,"subfield":{"id":"https://openalex.org/subfields/2740","display_name":"Pulmonary and Respiratory Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/atorvastatin","display_name":"atorvastatin","score":0.9950000047683716},{"id":"https://openalex.org/keywords/low-dose-statin-therapy","display_name":"low-dose statin therapy","score":0.8230000138282776},{"id":"https://openalex.org/keywords/limb-girdle-weakness","display_name":"limb-girdle weakness","score":0.9549999833106995},{"id":"https://openalex.org/keywords/statin-adverse-effects","display_name":"statin adverse effects","score":0.7889999747276306},{"id":"https://openalex.org/keywords/intravenous-immunoglobulin","display_name":"intravenous immunoglobulin","score":0.8999999761581421},{"id":"https://openalex.org/keywords/corticosteroids","display_name":"corticosteroids","score":0.8109999895095825},{"id":"https://openalex.org/keywords/methotrexate","display_name":"methotrexate","score":0.996999979019165},{"id":"https://openalex.org/keywords/immunosuppressive-therapy","display_name":"immunosuppressive therapy","score":0.734000027179718},{"id":"https://openalex.org/keywords/creatine-kinase-elevation","display_name":"creatine kinase elevation","score":0.7609999775886536}],"concepts":[{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.9811000227928162},{"id":"https://openalex.org/C2777482532","wikidata":"https://www.wikidata.org/wiki/Q668093","display_name":"Atorvastatin","level":2,"score":0.8220999836921692},{"id":"https://openalex.org/C2778715236","wikidata":"https://www.wikidata.org/wiki/Q55622662","display_name":"Discontinuation","level":2,"score":0.761900007724762},{"id":"https://openalex.org/C2781232998","wikidata":"https://www.wikidata.org/wiki/Q1433212","display_name":"Myositis","level":2,"score":0.7587000131607056},{"id":"https://openalex.org/C2780247198","wikidata":"https://www.wikidata.org/wiki/Q633403","display_name":"Weakness","level":2,"score":0.6510000228881836},{"id":"https://openalex.org/C2776418732","wikidata":"https://www.wikidata.org/wiki/Q270421","display_name":"Muscle weakness","level":2,"score":0.578499972820282},{"id":"https://openalex.org/C36880943","wikidata":"https://www.wikidata.org/wiki/Q409458","display_name":"Creatine kinase","level":2,"score":0.4896000027656555},{"id":"https://openalex.org/C2778616394","wikidata":"https://www.wikidata.org/wiki/Q474959","display_name":"myalgia","level":2,"score":0.4880000054836273},{"id":"https://openalex.org/C126322002","wikidata":"https://www.wikidata.org/wiki/Q11180","display_name":"Internal medicine","level":1,"score":0.459199994802475},{"id":"https://openalex.org/C197934379","wikidata":"https://www.wikidata.org/wiki/Q2047938","display_name":"Adverse effect","level":2,"score":0.42010000348091125},{"id":"https://openalex.org/C2779379848","wikidata":"https://www.wikidata.org/wiki/Q917069","display_name":"Rhabdomyolysis","level":2,"score":0.4007999897003174},{"id":"https://openalex.org/C2909745897","wikidata":"https://www.wikidata.org/wiki/Q270421","display_name":"Proximal muscle weakness","level":4,"score":0.3720000088214874},{"id":"https://openalex.org/C2781059491","wikidata":"https://www.wikidata.org/wiki/Q422232","display_name":"Methotrexate","level":2,"score":0.36390000581741333},{"id":"https://openalex.org/C2776839432","wikidata":"https://www.wikidata.org/wiki/Q954845","display_name":"Statin","level":2,"score":0.35569998621940613},{"id":"https://openalex.org/C2779075594","wikidata":"https://www.wikidata.org/wiki/Q8084905","display_name":"Autoimmune disease","level":3,"score":0.3472000062465668},{"id":"https://openalex.org/C90924648","wikidata":"https://www.wikidata.org/wiki/Q120569","display_name":"Gastroenterology","level":1,"score":0.33239999413490295},{"id":"https://openalex.org/C163764329","wikidata":"https://www.wikidata.org/wiki/Q785022","display_name":"Autoantibody","level":3,"score":0.31529998779296875},{"id":"https://openalex.org/C2779134260","wikidata":"https://www.wikidata.org/wiki/Q12136","display_name":"Disease","level":2,"score":0.31520000100135803},{"id":"https://openalex.org/C2779999465","wikidata":"https://www.wikidata.org/wiki/Q2094702","display_name":"Muscle biopsy","level":3,"score":0.2897999882698059},{"id":"https://openalex.org/C16005928","wikidata":"https://www.wikidata.org/wiki/Q171171","display_name":"Dermatology","level":1,"score":0.28760001063346863},{"id":"https://openalex.org/C141071460","wikidata":"https://www.wikidata.org/wiki/Q40821","display_name":"Surgery","level":1,"score":0.26919999718666077},{"id":"https://openalex.org/C203014093","wikidata":"https://www.wikidata.org/wiki/Q101929","display_name":"Immunology","level":1,"score":0.26269999146461487},{"id":"https://openalex.org/C2779701055","wikidata":"https://www.wikidata.org/wiki/Q929833","display_name":"Rare disease","level":3,"score":0.26170000433921814}],"mesh":[],"locations_count":3,"locations":[{"id":"doi:10.7759/cureus.102783","doi":"https://doi.org/10.7759/cureus.102783","is_oa":true,"landing_page_url":"https://doi.org/10.7759/cureus.102783","pdf_url":"https://www.cureus.com/articles/447959-statin-induced-necrotizing-autoimmune-myositis-presenting-with-progressive-limb-girdle-weakness-following-low-dose-atorvastatin-use.pdf","source":{"id":"https://openalex.org/S2738950867","display_name":"Cureus","issn_l":"2168-8184","issn":["2168-8184"],"is_oa":true,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core"],"host_organization":"https://openalex.org/P4310316779","host_organization_name":"Cureus, Inc.","host_organization_lineage":["https://openalex.org/P4310316779"],"host_organization_lineage_names":["Cureus, Inc."],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Cureus","raw_type":"journal-article"},{"id":"pmid:41783877","doi":null,"is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/41783877","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Cureus","raw_type":"Case Reports"},{"id":"pmh:oai:pubmedcentral.nih.gov:12955321","doi":null,"is_oa":true,"landing_page_url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC12955321/","pdf_url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC12955321/pdf/cureus-0018-00000102783.pdf","source":{"id":"https://openalex.org/S2764455111","display_name":"PubMed Central","issn_l":null,"issn":null,"is_oa":true,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"Cureus","raw_type":"Text"}],"best_oa_location":{"id":"doi:10.7759/cureus.102783","doi":"https://doi.org/10.7759/cureus.102783","is_oa":true,"landing_page_url":"https://doi.org/10.7759/cureus.102783","pdf_url":"https://www.cureus.com/articles/447959-statin-induced-necrotizing-autoimmune-myositis-presenting-with-progressive-limb-girdle-weakness-following-low-dose-atorvastatin-use.pdf","source":{"id":"https://openalex.org/S2738950867","display_name":"Cureus","issn_l":"2168-8184","issn":["2168-8184"],"is_oa":true,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core"],"host_organization":"https://openalex.org/P4310316779","host_organization_name":"Cureus, Inc.","host_organization_lineage":["https://openalex.org/P4310316779"],"host_organization_lineage_names":["Cureus, Inc."],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Cureus","raw_type":"journal-article"},"sustainable_development_goals":[{"display_name":"Good health and well-being","score":1.0,"id":"https://metadata.un.org/sdg/3"}],"sustainable_development_goals_aurora":[{"display_name":"Good health and well-being","score":0.8831063508987427,"id":"https://metadata.un.org/sdg/3"}],"study_designs":[{"display_name":"Case Report","id":"https://openalex.org/study-designs/case-report"}],"awards":[],"funders":[],"has_content":{"pdf":true,"grobid_xml":true},"content_urls":{"pdf":"https://content.openalex.org/works/W7127042576.pdf","grobid_xml":"https://content.openalex.org/works/W7127042576.grobid-xml"},"referenced_works_count":19,"referenced_works":["https://openalex.org/W2765714778","https://openalex.org/W2791516976","https://openalex.org/W3085623383","https://openalex.org/W3095637041","https://openalex.org/W3164657299","https://openalex.org/W4225257251","https://openalex.org/W4226437102","https://openalex.org/W4283032053","https://openalex.org/W4297081032","https://openalex.org/W4364375265","https://openalex.org/W4381052541","https://openalex.org/W4381799070","https://openalex.org/W4387157086","https://openalex.org/W4388448874","https://openalex.org/W4389822886","https://openalex.org/W4391529637","https://openalex.org/W4392290986","https://openalex.org/W4396661231","https://openalex.org/W4399048061"],"related_works":[],"abstract_inverted_index":{"Statins":[0],"are":[1,11],"a":[2,57,60],"mainstay":[3],"in":[4,95],"the":[5,42,48,83,89,96,132,142],"prevention":[6],"of":[7,41,50,59,68,75,82,93,98,144],"cardiovascular":[8],"disease":[9],"and":[10,33,44,115,140],"associated":[12],"with":[13,65,72,113],"rare":[14],"adverse":[15],"effects,":[16],"including":[17],"statin-induced":[18],"necrotizing":[19],"autoimmune":[20],"myositis":[21],"(SINAM).":[22],"This":[23,129],"condition":[24],"is":[25,45,88],"characterized":[26],"by":[27,47,105],"progressive,":[28],"symmetric,":[29],"proximal":[30],"muscle":[31],"weakness":[32,71],"elevated":[34],"creatine":[35],"kinase":[36],"(CK),":[37],"persisting":[38],"despite":[39],"discontinuation":[40],"statin,":[43],"confirmed":[46,104],"presence":[49],"anti-HMG-CoA":[51],"reductase":[52],"(HMGCR)":[53],"antibodies.":[54,107],"We":[55],"present":[56],"case":[58,92,130],"72-year-old":[61],"male":[62],"who":[63],"presented":[64],"three":[66],"months":[67],"progressive":[69],"limb-girdle":[70],"chronic":[73],"use":[74],"low-dose":[76,99],"atorvastatin":[77,100],"(10":[78],"mg).":[79],"Our":[80],"review":[81],"literature":[84],"suggests":[85],"that":[86],"this":[87],"first":[90],"documented":[91],"SINAM":[94,139],"setting":[97],"usage.":[101],"Diagnosis":[102],"was":[103,110],"anti-HMGCR":[106],"The":[108],"patient":[109],"initially":[111],"managed":[112],"corticosteroids":[114],"methotrexate":[116],"but":[117],"required":[118],"escalation":[119],"to":[120,126],"intravenous":[121],"immunoglobulin":[122],"(IVIG),":[123],"which":[124],"led":[125],"functional":[127],"improvement.":[128],"underscores":[131],"need":[133],"for":[134,138,146],"high":[135],"clinical":[136],"suspicion":[137],"highlights":[141],"importance":[143],"consideration":[145],"early":[147],"aggressive":[148],"immunosuppression.":[149]},"counts_by_year":[{"year":2026,"cited_by_count":1}],"updated_date":"2026-09-26T08:19:03.415552","created_date":"2026-02-03T00:00:00"}