Isolated gluteal and paravertebral muscle weakness due to anti-3-hydroxy-3-methylglutaryl-coenzyme a reductase antibody-associated necrotizing autoimmune myopathy

Immune-Mediated Myopathy in a Patient Presenting for Melanoma Resection and Sentinel Lymph Node Biopsy

Statin-induced necrotizing autoimmune myopathy (SINAM) is a rare side effect in people who are taking a class of drugs called statins. Patients with SINAM will present with subacute severe symmetric proximal muscle weakness. In contrast to more common myopathies, SINAM may not spontaneously resolve with statin discontinuation. These patients may require long-term immunotherapy to limit further disease progression. In this case study, we report a 74-year-old female with SINAM who presented for radical excision of a right upper back melanoma and sentinel lymph node biopsy at an outpatient facility. An anesthetic plan was crafted with the use of a supraglottic airway device without neuromuscular blockade.