Neutrophilia in Patients on Statin Therapy

Differential Diagnosis and Management

• The American College of Cardiology recommends that statin-associated myopathy can cause muscle pain and elevated creatine kinase but does NOT typically cause leukocytosis or neutrophilia 1, 2
• The American College of Cardiology suggests that if statin myopathy is diagnosed, statin therapy should be discontinued immediately if CK is markedly elevated or myopathy is diagnosed, and rechallenge with alternative statin at lower dose once symptoms resolve and CK normalizes 4, 5
• The American Heart Association indicates that statins can cause muscle injury, but not leukocytosis; neutrophilia indicates infection or inflammation requiring separate evaluation 1, 2
• The American College of Cardiology advises against attributing neutrophilia to statin therapy alone, as statins cause muscle injury but not leukocytosis; neutrophilia indicates infection or inflammation requiring separate evaluation 1, 2
• The American College of Cardiology recommends that CK should only be checked in patients with severe muscle symptoms or objective weakness, and not routinely measured in asymptomatic patients 4, 5