Conclusions

This single case highlights that severe statin-associated myopathy should be considered in statin-treated patients presenting with progressive myalgia, proximal weakness, and functional decline. Early CK testing and the prompt discontinuation of the statin are essential. Persistent hyperCKemia after statin withdrawal warrants specialist assessment and confirmatory evaluation for immune-mediated disease, including anti-HMGCR antibody testing, together with continued clinical and laboratory follow-up to document CK normalization and the recovery of muscle strength. Aminotransferase elevation in this setting may reflect skeletal muscle injury and should be interpreted alongside CK, bilirubin, GGT, alkaline phosphatase, and renal function.