Statin-Induced Autoimmune Necrotizing Myopathy.

Abstract

Statin therapy is a widely prescribed medication class for hypercholesterolemia. In statin-induced autoimmune myopathy, genetically predisposed and at-risk patients can develop antibodies against hydroxy-3-methylglutaryl-CoA reductase (HMGCR), the key enzyme in the production of cholesterol. As a result, an autoimmune reaction causing weakness, myalgia, with possible severe rhabdomyolysis, renal failure, and myonecrosis also can occur. A 73-year-old female presented to clinic with myalgia and fatigue. She was on atorvastatin 20 mg/day for over 1 year, which she stopped 1 week prior to her initial presentation. Patient did experience rhabdomyolysis as well as a transaminitis. She underwent an autoimmune workup which was positive for HMG-CoA reductase antibodies. Patient was initially treated on a prednisone taper, starting dose 50 mg/day. Without remission of symptoms, methotrexate 15 mg/week was initiated.

• Authors: Sahani Jayatilaka, Kunal Desai, Swarup Rijal, Debra Zimmerman
• Journal: Journal of primary care & community health (J Prim Care Community Health) 2021 Jan-Dec Vol. 12 Pg. 21501327211028714 ISSN: 2150-1327 [Electronic] United States
• PMID: 34219515 (Publication Type: Case Reports, Journal Article)

Chemical References

• Autoantibodies
• Hydroxymethylglutaryl-CoA Reductase Inhibitors

Topics

• Aged
• Autoantibodies
• Autoimmune Diseases (chemically induced, drug therapy)
• Female
• Humans
• Hydroxymethylglutaryl-CoA Reductase Inhibitors (adverse effects)
• Muscular Diseases (chemically induced)
• Myositis