Mumbai: Woman diagnosed with extremely rare autoimmune illness, recovering

Within a month of taking statins, the patient started developing pain in her muscles and knees. Representation pic

At the age of 62, Manju Singh from Bihar became a rare case when she was diagnosed with statin-induced muscle disorder at Mumbai's Jaslok Hospital. In January, Manju had visited a hospital in Patna where she underwent angioplasty for ischaemic heart disease.

"The procedure went fine and she was discharged with a few medications for her to recover soon," said Lalji Singh, her husband.

The medications belonged to a group called statins, which are commonly used to lower cholesterol levels. Within a month after the procedure, Manju started developing pain in her muscles and knees.

"We rushed to an orthopaedic soon after these symptoms first appeared. We only saw her condition worsen after a few days of treatment there," Singh said. Her health had started to deteriorate, so much so that even maintaining adequate food intake became a tough battle as she would vomit immediately.

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By about April, her renal function was severely impacted. After consulting more doctors and hospitals in Patna, in July the couple's daughter who resides in Mumbai suggested a visit to a specialist in the city.

It was here that the family finally had the answer to what was happening to Manju. "Her body was slowly giving up on her, in medical terms it was necrotising autoimmune myopathy," said Dr Vinaya Bhandari, a neurologist at Jaslok Hospital.

NAM is a rare autoimmune disease that causes severe muscle weakness and muscle tissue damage due to the body's immune system mistakenly attacking its own muscle cells. This was the rarest of the rare cases where statins had caused this backfiring, Dr Bhandari said.

"Statin is not the cause of muscle symptoms in more than 90 per cent of individuals who report such symptoms," concluded a comprehensive analysis published in Lancet that looked at the risks due to statins.

Statins are largely safe and life-saving medicines sometimes prescribed for lifelong use and there is no need to panic, Dr Bhandari said. "What Manju went through is the rarest of the rare side effects of statins and people need to contact their doctors after initial signs of muscle weakness and pain," she said, adding that Manju's condition worsened because the ailment was not immediately diagnosed.

Swift intervention with intravenous immunoglobulin (IVIg) therapy and immunosuppressive treatment yielded significant improvements in her condition. This treatment is widely available at government and BMC-run facilities along with private facilities. "She responded to it and is now recovering," Dr Bhandari said.