Statin induced myopathy differential diagnosis

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Rim Halaby

Myalgia is a common complaint and should not be attributed directly to the use of statins. The patient should be evaluated for any thyroid problems, inflammatory processes, alcohol use, excessive exercise, electrolyte disturbances, side effects of other medications or vitamin deficiencies.^[1]

• Alcohol-related myopathy
• Arthritis
  • Degenerative arthritis
  • Inflammatory arthritis
• Connective tissue diseases
  • Polymyalgia rheumatica
  • Rheumatoid arthritis
  • Systemic lupus erythematosis
  • Sjögren syndrome
• Electrolyte abnormalities
  • Hypokalemia
  • Hypomagnesemia secondary to diuretic use
• Endocrine abnormalities
  • Addison disease
  • Acromegaly
  • Cushing syndrome
  • Hypoparathyroidism, hyperparathyroidism
  • Hypothyroidism, hyperthyroidism
• Fibromyalgia
• Guillain-Barré syndrome
• Metabolic myopathies
  • Carnitine palmitoyltransferase II (CPT II) deficiency
  • McArdle disease
  • Mitochondrial myopathies
• Muscle pain and myopathy from non-statin drugs
  • Bisphosphonates
  • Zidovudine (Retrovir)
  • Vitamin E
• Myelopathy, spinal stenosis
• Myositis
  • Dermatomyositis
  • Inclusion body myositis
  • Polymyositis
• Peripheral neuropathy
  • Diabetes
  • Idiopathic
  • Spinal stenosis
  • Vitamin B12 deficiency
• Peripheral vascular disease
• Progressive neuromuscular atrophy
  • Amyotrophic lateral sclerosis
  • Charcot-Marie-Tooth disease
  • Multiple sclerosis
  • Spinal muscular atrophy
• Vitamin D deficiency^[1]