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Medical Grand Rounds

Myopathy for the general internist: Statins and much more

Chester V. Oddis, MD
Cleveland Clinic Journal of Medicine October 2019, 86 (10) 656-664; DOI: https://doi.org/10.3949/ccjm.86gr.19001
Chester V. Oddis
Myositis Center, Department of Medicine; Professor of Medicine, University of Pittsburgh, Pittsburgh, PA
Roles: Director
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  • Figure 1
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    Figure 1

    Strategy for evaluating statin-related myopathy.

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    TABLE 1

    Polymyositis mimics

    Endocrine myopathies
     Hyperthyroidism
     Hypothyroidism
    Drug or toxic myopathies
    Metabolic myopathies
    Mitochondrial myopathies
    Muscular dystrophies
    Infectious myositis
    Neuropathies and neurologic syndromes
    Paraneoplastic syndromes
    Other connective tissue disorders
    Miscellaneous
     Amyloidosis
     Sarcoidosis
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    TABLE 2

    Systemic manifestations of myositis

    Musculoskeletal
    Weakness
    Muscle pain or tenderness
    Muscle atrophy
    Arthralgias
    Arthritis
    Gastrointestinal
    Dysphagia
    Reflux
    Dysmotility
    Cutaneous
    Rash
    Calcification
    Cardiac
    Arrhythmias
    Congestive failure
    Pulmonary
    Interstitial lung disease
    Aspiration pneumonia
    Interstitial fibrosis
    General
    Fever
    Fatigue
    Weight loss
    Raynaud phenomenon
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    TABLE 3

    Antiantisynthetase autoantibodies

    AntibodyAntigen (tRNA synthetase)Prevalence in idiopathic inflammatory myopathy (%)
    Jo-1Histidyl20–30
    PL-7Threonyl<5
    PL-12Alanyl<5
    OJIsoleucyl< 5
    EJGlycyl< 5
    KSAsparaginyl< 1
    TryTyrosyl< 1
    ZoPhenylalanyl< 1
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Cleveland Clinic Journal of Medicine: 86 (10)
Cleveland Clinic Journal of Medicine
Vol. 86, Issue 10
1 Oct 2019
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Myopathy for the general internist: Statins and much more
Chester V. Oddis
Cleveland Clinic Journal of Medicine Oct 2019, 86 (10) 656-664; DOI: 10.3949/ccjm.86gr.19001

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Myopathy for the general internist: Statins and much more
Chester V. Oddis
Cleveland Clinic Journal of Medicine Oct 2019, 86 (10) 656-664; DOI: 10.3949/ccjm.86gr.19001
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  • Article
    • ABSTRACT
    • FOCUSING THE EVALUATION
    • CASE 1: SLOWLY PROGRESSIVE WEAKNESS
    • CASE 2: MILD MYALGIA WITHOUT WEAKNESS
    • CLASSIFYING MYOSITIS
    • CASE 3: WEAKNESS, VERY HIGH CK ON A STATIN
    • CASE 4: FEVER, NEW ‘RHEUMATOID ARTHRITIS,’ AND LUNG DISEASE
    • CASE 5: FEVER, UNDIAGNOSED LUNG DISEASE, NO MYOSITIS
    • CASE 6: DERMATOMYOSITIS, RAPIDLY PROGRESSIVE INTERSTITIAL LUNG DISEASE
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