A 48 year old lady presented with a 7-week history of progressive generalised myalgia and muscle weakness resulting in recurrent falls. Her past medical history included bipolar affective disorder and a previous stroke. Her medications included clopidogrel 75mg, atorvastatin 80mg, and quetiapine 400mg twice daily.

References

1. Costa AF, Di Primio GA, Schweitzer ME. Magnetic resonance imaging of muscle disease: A pattern-based approach, Muscle & Nerve, 2012, Vol 46 (4): 465-481. URL: https://onlinelibrary.wiley.com/doi/full/10.1002/mus.23370?casa_token=VfJG3hhu-4sAAAAA%3ApPYwf5F9EXM-_bW8JbvhzlF6IwM7XeiexkKzsxgSA_mHpzp1zagDXJ3T01CdTl0QyaPxfziEk66Gjg
2. Smitaman E, Flores DV, Gomez CM, Pathria MN. MR Imaging of Atraumatic Muscle Disorders, RadioGraphs, 2018, vol 38(2): 500-522. URL: https://pubs.rsna.org/doi/10.1148/rg.2017170112?url_ver=Z39.88-2003&rfr_id=ori%3Arid%3Acrossref.org&rfr_dat=cr_pub++0pubmed&#
3. Thomas X, Milisenda JC, Garcia-Diez AI. Whole-body MRI and pathological findings in adult patients with myopathies, Skeletal Radiology, 2018, vol. 48(5): 653-676. URL: https://link.springer.com/article/10.1007/s00256-018-3107-1
4. Chawla J. Stepwise Approach to Myopathy in Systemic Disease, Frontiers in Neurology, 2011 Vol. 2: 49. URL: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3153853/
5. Suresh E, Wimalaratna S. Proximal myopathy: diagnostic approach and initial management, Postgraduate Medical Journal, 2013, Vol. 89: 470-477. URL: https://pmj.bmj.com/content/89/1054/470
6. Schmidt J. Current Classification and Management of Inflammatory Myopathies, Journal of Neuromuscular Diseases, 2018, Vol. 5(2): 109-129. URL: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6004913/
7. Lundberg IE, Visser M, Werth VP. Classification of myositis, Nature Review Rheumatology, 2018, vol 14: 269-278. URL: https://www.nature.com/articles/nrrheum.2018.41
8. Valiyil R, Christopher-Stine L. Drug-related Myopathies of Which the Clinician Should Be Aware, Current Rheumatology Reports, 2010, Vol 12: 213-220. URL: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3092639/#
9. Cordeiro AC, Isenberg DA. Treatment of inflammatory myopathies, Postgraduate Medical Journal, 2006, vol 82(969): 417-424. URL: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2563757/
10. Wiendl H. Idiopathic inflammatory myopathies: Current and future therapeutic options, Neurotherapeutics, 2008, vol 5(4): 548-55. URL: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4514694/
11. Amato AA, Griggs RC. Treatment of idiopathic inflammatory myopathies, Current Opinion in Neurology, 2003, vol 16(5): 565-575. URL: https://pubmed.ncbi.nlm.nih.gov/14501840/
12. Souayah N. Idiopathic Inflammatory Myopathies, BMJ Best Practice, 2018
13. Pinal-Fernandez I, Casal-Dominguez M, Mammen AL. immune-Mediated Necrotizing Myopathy, Current Rheumatology Reports, 2018, Vol 20(4): 21. URL: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6019613/#
14. Stephani C, Trenkwalder C. Rhabdomyolysis after low-dose queiatpine in a patient with Parkinson’s disease with drug-induced psychosis: A case Report, Movement Disorders, 2010, vol 25(6): 790-791. URL: https://movementdisorders.onlinelibrary.wiley.com/doi/full/10.1002/mds.23015
15. Fountoulakis KN, Lacovides A, Kaprinis SG. Diffuse muscle pain with quetiapine, The British Journal of Psychiatry, 2018, vol 182(1): 81. URL: https://www.cambridge.org/core/journals/the-british-journal-of-psychiatry/article/diffuse-muscle-pain-with-quetiapine/929F617326163F41CBBB0EEE13D8E34F
16. Ceri M, Unverdi S, Altay M, Duranay M. Low-Dose Quetiapine-Induced Severe Rhabdomyolysis, Renal Failure, 2011, Vol 33(4): 463-464. URL: https://www.tandfonline.com/doi/full/10.3109/0886022X.2011.568141
17. Velasco-Montes J, Orinuela-Gonzalez I, Sanjuan-Lopez AZ. Rhabdomyolysis secondary to quetiapine, ActasEspañolas de Psiquiatría, 2012, vol 40(2): 97-99. URL: https://pubmed.ncbi.nlm.nih.gov/22508075/