Autoimmune necrotising myopathy and HMGCR antibodies

Karunaratne, Kushan; Amiras, Dimitri; Pickering, Matthew C.; Hofer, Monika; Viegas, Stuart

doi:10.1136/practneurol-2017-001848

Cited by 9 publications

(5 citation statements)

References 10 publications

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“…Other myositis-inducing antibodies were negative and were less likely to be the cause of her myositis. The patient reported improvement in symptoms after the statin was stopped, and she received intravenous immunoglobulin [ 3 , 4 ]. This improvement in symptoms after stopping the offending agent also points to the likelihood that her necrotizing myositis was statin-induced though we agree that most of her rapid improvement was due to steroid therapy.…”

Section: Discussionmentioning

confidence: 99%

Statin-Induced Autoimmune Necrotizing Myositis: A Case Report

Almadhoun¹,

Mesiha²

2022

Cureus

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Statin therapy is considered one of the main therapies indicated to reduce the risk of cardiovascular death in patients with atherosclerotic cardiovascular disease. Maximal risk reduction is linked to the degree of reduction of the low-density lipoprotein cholesterol; therefore, high-intensity dosing is required with coronary artery disease. Musculoskeletal side effects are reported with the use of statin, especially at high doses. Although myopathy is a common side effect, autoimmune-mediated necrotizing myositis is a rare side effect usually related to the development of hydroxymethylglutaryl-coenzyme A reductase antibodies which attack the muscles leading to swelling manifesting as muscle weakness and pain, as presented in our case report.

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Section: Discussionmentioning

confidence: 99%

Statin-Induced Autoimmune Necrotizing Myositis: A Case Report

Almadhoun¹,

Mesiha²

2022

Cureus

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“…IMNM is characterized by anti-HMG CR antibody or anti-SRP positivity in more severe form, than Ab negative with early treatment resulting in better outcomes [10,11]. Anti-HMG CR was strongly predictive in the diagnosis of statin-induced IMNM [12,13]. However, antibodies are not specific to IMNM in statin exposed versus unexposed patients [14].…”

Section: Discussionmentioning

confidence: 99%

Atorvastatin-Induced Necrotizing Myopathy and its Response to Combination Therapy

Boppana¹,

Syed²,

Antwi‐Amoabeng³

et al. 2021

Cureus

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Atorvastatin is the most commonly used statin medication to decrease cholesterol levels and prevent atherosclerosis. Myopathy is a reported side effect of atorvastatin which can happen even after more than six months after starting the medication. The side effect on the muscle tissue can range from simple reversible myalgia to respiratory muscle compromise. Here we present a 46-year-old male who presented with myopathy after taking atorvastatin for two years. Biopsy proved immune-mediated necrotizing myopathy which responded to a combination of Rituximab and intravenous immunoglobulin therapy.

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“…The symptoms usually progress despite stopping the statin. In two cases reported in this edition of Practical Neurology ,28 the myopathy resolved on statin withdrawal without additional treatment; however, in an interesting variation on the theme, the myopathy recurred in one patient when statins were introduced 4 years later did not resolve on statin withdrawal the second time and so required immunosuppressant treatment. The muscle biopsy shows features of an immune-mediated necrotising myopathy.…”

Section: Statin-related Myopathiesmentioning

confidence: 96%

Statin-related myopathies

Hilton‐Jones

2018

Pract Neurol

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Statins are the Marmite ('You either love it or hate it!') of the drug world, both in terms of therapeutic benefit and risk of side effects. Proponents think that they are potential life-savers, opponents that their main benefit is lining the pockets of pharma. Some consider side effects to be a major issue, outweighing any therapeutic benefit, others that they are rare and essentially innocuous. Statin-induced myalgia is relatively common but often mild and for most people does not limit treatment. In others, reducing the dose or changing the preparation may help. In all, withdrawal of the statin leads to resolution. Statin-induced rhabdomyolysis, most often precipitated by drug-drug interaction, affects only a tiny proportion of statin users, but because of the widespread prescribing of statins is an important clinical problem. Statin-induced immune-mediated necrotising myopathy represents a novel disease mechanism and clinically mimics forms of myositis. Resolution often requires immunosuppressant drug treatment, as well as statin withdrawal.

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Autoimmune necrotising myopathy and HMGCR antibodies

Cited by 9 publications

References 10 publications

Statin-Induced Autoimmune Necrotizing Myositis: A Case Report

Statin-Induced Autoimmune Necrotizing Myositis: A Case Report

Atorvastatin-Induced Necrotizing Myopathy and its Response to Combination Therapy

Statin-related myopathies

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