Anti-HMGCR myopathy mimicking facioscapulohumeral muscular dystrophy

Statin use can lead to various muscle-related issues, including benign creatine kinase (CK) elevations, myalgias, toxic myopathies, rhabdomyolysis, and immune-mediated necrotizing myositis (IMNM), which primarily affects older males. IMNM presents with proximal muscle weakness, elevated CK levels, a...

Full description

Saved in:
Bibliographic Details
Published in:Open medicine (Warsaw, Poland) Poland), 2024-09, Vol.19 (1), p.20241033-7
Main Authors: Braun, Andreas Albert, Atiya, Monika, Göhner, Katja, Hortobagyi, Tibor, Burkhardt, Tobias, Schreiner, Bettina
Format: Article
Language:English
Subjects:
anti-HMG-CoA reductase antibodies
Antibodies
Apoptosis
Atrophy
Biopsy
case report
Case reports
facioscapulohumeral muscular dystrophy
Family medical history
FSHD
Hospitals
immune-mediated necrotizing myopathy
Immunoglobulins
Kinases
Muscular dystrophy
Neuromuscular diseases
Paresis
Stroke
Citations: Items that this one cites
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Statin use can lead to various muscle-related issues, including benign creatine kinase (CK) elevations, myalgias, toxic myopathies, rhabdomyolysis, and immune-mediated necrotizing myositis (IMNM), which primarily affects older males. IMNM presents with proximal muscle weakness, elevated CK levels, and specific antibodies. We describe a 72-year-old patient with muscle weakness persisting for over 3 years after statin therapy. Initially suspected to have a genetic disorder, further testing revealed elevated anti-3-hydroxy-3-methylglutaryl coenzyme A reductase (HMGCR) antibodies, indicating immune-mediated myopathy. Despite the absence of inflammatory changes on biopsy, the patient responded positively to immune therapy. This case highlights challenges in diagnosing immune-mediated myopathy, especially in older patients with atypical presentations. Testing for HMGCR antibodies can aid in diagnosis, particularly when inflammatory markers are absent. Awareness of red flags, such as delayed symptom onset and response to prednisone, is crucial for accurate diagnosis and management.
ISSN:2391-5463
2391-5463
DOI:10.1515/med-2024-1033