Conclusion
A patient presenting with ongoing symmetrical muscle weakness after
statin discontinuation with elevated CK levels should have anti-HMG-CoA
reductase antibodies checked. Together with positive anti-HMGCR and
supporting evidence of MRI or muscle biopsy consistent with necrotizing
myopathy, the diagnosis of statin-induced IMNM is highly suspicious.
This should lead to the initiation of immunosuppressive therapy and
long-term follow-up.