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Chronic Onset Form of Anti-HMG-CoA Reductase Myopathy
Noel Lorenzo-Villalba1, Emmanuel Andrès1, Alain Meyer2
1Service de Médecine Interne, Diabète et Maladies Métaboliques, Hôpitaux Universitaires de Strasboug, France.
Abstract:
We report a case of anti-HMGCR myopathy mimicking limb-girdle muscular dystrophy in a 27-year-old male patient with no history of statin intake and presenting with a chronic onset form over 3 years. Treatment with prednisone and methotrexate was initiated with an insufficient response, so intravenous immunoglobulin was added. One year after initial treatment was started, as levels of creatine kinase (CK) were >1000 U/l, treatment with rituximab was added. Despite a 3-year delay before treatment, muscle strength improved even though CK levels remain elevated.
Learning Points:
We describe a case of anti-HMGCR myopathy mimicking limb-girdle muscular dystrophy, which resulted in delayed diagnosis and management.The patient's muscular strength improved but creatine kinase levels remain elevated despite comprehensive treatment.
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