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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...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Taylor & Francis
2019
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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. |
format | Online Article Text |
id | pubmed-6374921 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Taylor & Francis |
record_format | MEDLINE/PubMed |
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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