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Anti-HMGCR antibody-associated necrotising myopathy and its association with statin use

Ylenia Abdilla1, Charmaine Chircop1, Norbert Vella1

  • 1Neuroscience, Mater Dei Hospital, Msida, Malta.

BMJ Case Reports
|November 14, 2018
PubMed

Insights

A man developed muscle weakness and pain, worsening with statin use. Diagnosis confirmed anti-HMGCR antibody myopathy, treated successfully with immunosuppression.

Area of Science:

  • Neurology
  • Immunology
  • Rheumatology

Background:

  • Statins are commonly prescribed for hyperlipidemia but can rarely cause myopathy.
  • Autoimmune myopathies are a group of rare disorders characterized by muscle inflammation and weakness.

Observation:

  • A 66-year-old male presented with a year of generalized weakness, aches, and chest pain, with symptom exacerbation after initiating statin therapy.
  • Clinical presentation included elevated creatine kinase, positive anti-HMGCR antibody titers, myopathic findings on EMG and muscle biopsy, and MRI-detected muscle atrophy.

Findings:

  • The patient's presentation and investigation results were consistent with anti-HMGCR antibody-associated myopathy.
  • Anti-HMGCR antibody myopathy is a distinct autoimmune condition linked to statin use in some cases.

Implications:

  • Early recognition and diagnosis of anti-HMGCR antibody myopathy are crucial for appropriate management.
  • Immunosuppressive therapy can be effective in treating anti-HMGCR antibody myopathy, leading to symptom improvement.
  • This case highlights the importance of considering autoimmune etiologies in statin-induced myopathy.

Keywords:
muscle diseaseneuro geneticsunwanted effects/adverse reactions

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