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Statin-Induced Autoimmune Necrotizing Myopathy

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 re...

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Autores principales: Jayatilaka, Sahani, Desai, Kunal, Rijal, Swarup, Zimmerman, Debra
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8255573/
https://www.ncbi.nlm.nih.gov/pubmed/34219515
http://dx.doi.org/10.1177/21501327211028714
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author Jayatilaka, Sahani
Desai, Kunal
Rijal, Swarup
Zimmerman, Debra
author_facet Jayatilaka, Sahani
Desai, Kunal
Rijal, Swarup
Zimmerman, Debra
author_sort Jayatilaka, Sahani
collection PubMed
description 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.
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spelling pubmed-82555732021-07-16 Statin-Induced Autoimmune Necrotizing Myopathy Jayatilaka, Sahani Desai, Kunal Rijal, Swarup Zimmerman, Debra J Prim Care Community Health Case Studies 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. SAGE Publications 2021-07-03 /pmc/articles/PMC8255573/ /pubmed/34219515 http://dx.doi.org/10.1177/21501327211028714 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by-nc/4.0/This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Case Studies
Jayatilaka, Sahani
Desai, Kunal
Rijal, Swarup
Zimmerman, Debra
Statin-Induced Autoimmune Necrotizing Myopathy
title Statin-Induced Autoimmune Necrotizing Myopathy
title_full Statin-Induced Autoimmune Necrotizing Myopathy
title_fullStr Statin-Induced Autoimmune Necrotizing Myopathy
title_full_unstemmed Statin-Induced Autoimmune Necrotizing Myopathy
title_short Statin-Induced Autoimmune Necrotizing Myopathy
title_sort statin-induced autoimmune necrotizing myopathy
topic Case Studies
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8255573/
https://www.ncbi.nlm.nih.gov/pubmed/34219515
http://dx.doi.org/10.1177/21501327211028714
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