Dr. Somesh Sharma (General Practice) needs a second opinion on this medical case.
A 66 y/o female complains of weakness in the right leg for 2 months. The problem started with weakness in the left foot and leg which leads to weakness in the right leg and then bilateral upper limbs.
Clinical examination revealed a proximal paresis in the arms and legs.
Creatine kinase : 7953 U/L (reference interval <150 U/L). Electromyography showed myogenic changes. A toxic statin myopathy was considered, although the time span between the start of the statin and onset of the symptoms was long.
There was some evidence of endomysial fibrosis without inflammatory infiltration. Individual muscle fibers showed necrosis with myocyte phagocytosis and without HLA-ABC upregulation.
What are your comments?