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Anti-HMG-CoA reductase myopathy, an undesirable evolution of statin induced myopathy: a case report

Statins are commonly used lipid lowering agents which play a pivotal role in reducing cardiovascular morbidity and mortality. Often well tolerated, these HMG-CoA reductase (HMGCR) inhibitors can sometimes cause severe muscle weakness and elevated creatinine kinase (CK) often labeled as statin intole...

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Autores principales: Upreti, Sunita, Fayyaz, Beenish, Bongu, Ramchandran P.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Taylor & Francis 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6374921/
https://www.ncbi.nlm.nih.gov/pubmed/30788073
http://dx.doi.org/10.1080/20009666.2019.1571882
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author Upreti, Sunita
Fayyaz, Beenish
Bongu, Ramchandran P.
author_facet Upreti, Sunita
Fayyaz, Beenish
Bongu, Ramchandran P.
author_sort Upreti, Sunita
collection PubMed
description Statins are commonly used lipid lowering agents which play a pivotal role in reducing cardiovascular morbidity and mortality. Often well tolerated, these HMG-CoA reductase (HMGCR) inhibitors can sometimes cause severe muscle weakness and elevated creatinine kinase (CK) often labeled as statin intolerance or statin induced myopathy. These symptoms improve after discontinuation of the offending drug along with normalization of the enzyme levels. However, an entity called Immune Mediated Necrotizing Myopathy (IMNM), a type of autoimmune mediated myopathy, has been recognized and characterized in patients with history of statin exposure where there is persistence of proximal muscle weakness, CK elevation and myofiber necrosis can be seen on muscle biopsy even after stopping statins. With the increased use of statins, there seems to be a higher incidence of IMNM cases in recent years. Here we discuss a case of anti-HMG-CoA myopathy, one of the three recognized types of IMNM that has been more commonly associated with statin exposure and highly responsive to immunotherapy.
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spelling pubmed-63749212019-02-20 Anti-HMG-CoA reductase myopathy, an undesirable evolution of statin induced myopathy: a case report Upreti, Sunita Fayyaz, Beenish Bongu, Ramchandran P. J Community Hosp Intern Med Perspect Case Report Statins are commonly used lipid lowering agents which play a pivotal role in reducing cardiovascular morbidity and mortality. Often well tolerated, these HMG-CoA reductase (HMGCR) inhibitors can sometimes cause severe muscle weakness and elevated creatinine kinase (CK) often labeled as statin intolerance or statin induced myopathy. These symptoms improve after discontinuation of the offending drug along with normalization of the enzyme levels. However, an entity called Immune Mediated Necrotizing Myopathy (IMNM), a type of autoimmune mediated myopathy, has been recognized and characterized in patients with history of statin exposure where there is persistence of proximal muscle weakness, CK elevation and myofiber necrosis can be seen on muscle biopsy even after stopping statins. With the increased use of statins, there seems to be a higher incidence of IMNM cases in recent years. Here we discuss a case of anti-HMG-CoA myopathy, one of the three recognized types of IMNM that has been more commonly associated with statin exposure and highly responsive to immunotherapy. Taylor & Francis 2019-02-11 /pmc/articles/PMC6374921/ /pubmed/30788073 http://dx.doi.org/10.1080/20009666.2019.1571882 Text en © 2019 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group on on behalf of Greater Baltimore Medical Center. http://creativecommons.org/licenses/by-nc/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Upreti, Sunita
Fayyaz, Beenish
Bongu, Ramchandran P.
Anti-HMG-CoA reductase myopathy, an undesirable evolution of statin induced myopathy: a case report
title Anti-HMG-CoA reductase myopathy, an undesirable evolution of statin induced myopathy: a case report
title_full Anti-HMG-CoA reductase myopathy, an undesirable evolution of statin induced myopathy: a case report
title_fullStr Anti-HMG-CoA reductase myopathy, an undesirable evolution of statin induced myopathy: a case report
title_full_unstemmed Anti-HMG-CoA reductase myopathy, an undesirable evolution of statin induced myopathy: a case report
title_short Anti-HMG-CoA reductase myopathy, an undesirable evolution of statin induced myopathy: a case report
title_sort anti-hmg-coa reductase myopathy, an undesirable evolution of statin induced myopathy: a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6374921/
https://www.ncbi.nlm.nih.gov/pubmed/30788073
http://dx.doi.org/10.1080/20009666.2019.1571882
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