Autoimmune anti-HMGCR myopathy: a rare but disabling complication of statin therapy
Presentation
An 85-year-old farmer developed disabling progressive proximal limb weakness and dysphagia after 10 years of statin therapy.
Diagnosis
Creatine kinase was elevated, and electromyography demonstrated myopathic abnormalities. A muscle biopsy confirmed a necrotising myopathy. Serum 3-hydroxy-3-methylglutaryl coenzyme A reductase (HMGCR) antibodies were positive. These investigations confirmed a diagnosis of autoimmune anti-HMGCR myopathy.
Treatment
The statin was stopped and treatment with steroids, intravenous immunoglobulins and rituximab yielded minimal clinical improvement over 1 year.
Conclusion
Autoimmune anti-HMGCR myopathy is a rare complication of statin therapy. In severe cases earlier treatment with multiple immunotherapies may be necessary.
History
Comments
The original article is available at www.imj.iePublished Citation
O'Dea I. et al. Autoimmune anti-HMGCR myopathy: a rare but disabling complication of statin therapy. Ir Med J. 2021;114(8):444Publication Date
September 2021Department/Unit
- Beaumont Hospital
Publisher
Irish Medical AssociationVersion
- Published Version (Version of Record)
