TY - JOUR
T1 - An Unusual Case of Statin-Induced Myopathy
T2 - Anti-HMGCoA Necrotizing Autoimmune Myopathy
AU - Nichols, Laura
AU - Pfeifer, Kurt
AU - Mammen, Andrew L.
AU - Shahnoor, Nazima
AU - Konersman, Chamindra G.
PY - 2015/4/9
Y1 - 2015/4/9
N2 - Statins are some of the most widely prescribed medications, and though generally well tolerated, can lead to a self-limited myopathy in a minority of patients. Recently, these medications have been associated with a necrotizing autoimmune myopathy (NAM). Statin-associated NAM is characterized by irritable myopathy on electromyography (EMG) and muscle necrosis with minimal inflammation on muscle biopsy. The case presented is a 63-year-old woman who has continued elevation of creatine kinase (CK) after discontinuation of statin therapy. She has irritable myopathy on EMG and NAM is confirmed by muscle biopsy. She subsequently tests positive for an experimental anti-3-hydroxy-3-methylglutaryl-coenzyme A (anti-HMGCoA) antibody that is found to be present in patients with statin-associated NAM. Though statin-associated NAM is a relatively rare entity, it is an important consideration for the general internist in patients who continue to have CK elevation and weakness after discontinuation of statin therapy. Continued research is necessary to better define statin-specific and dose-dependent risk, as well as optimal treatment for this condition.
AB - Statins are some of the most widely prescribed medications, and though generally well tolerated, can lead to a self-limited myopathy in a minority of patients. Recently, these medications have been associated with a necrotizing autoimmune myopathy (NAM). Statin-associated NAM is characterized by irritable myopathy on electromyography (EMG) and muscle necrosis with minimal inflammation on muscle biopsy. The case presented is a 63-year-old woman who has continued elevation of creatine kinase (CK) after discontinuation of statin therapy. She has irritable myopathy on EMG and NAM is confirmed by muscle biopsy. She subsequently tests positive for an experimental anti-3-hydroxy-3-methylglutaryl-coenzyme A (anti-HMGCoA) antibody that is found to be present in patients with statin-associated NAM. Though statin-associated NAM is a relatively rare entity, it is an important consideration for the general internist in patients who continue to have CK elevation and weakness after discontinuation of statin therapy. Continued research is necessary to better define statin-specific and dose-dependent risk, as well as optimal treatment for this condition.
KW - anti-HMGCR antibody
KW - idiopathic inflammatory myopathy
KW - necrotizing autoimmune myopathy
KW - statin
UR - http://www.scopus.com/inward/record.url?scp=84946499756&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84946499756&partnerID=8YFLogxK
U2 - 10.1007/s11606-015-3303-9
DO - 10.1007/s11606-015-3303-9
M3 - Article
C2 - 25855481
AN - SCOPUS:84946499756
SN - 0884-8734
VL - 30
SP - 1879
EP - 1883
JO - Journal of General Internal Medicine
JF - Journal of General Internal Medicine
IS - 12
ER -