Statins and Immune-Mediated Necrotizing Myopathy
Statins are a well-recognized cause of a variety of skeletal myopathic effects, which generally resolve when discontinuing the treatment. Among autoimmune manifestations associated with statins, there is immune-mediated necrotizing myopathy (IMNM). The present article summarizes the main features o...
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doaj-0d2b63cdfc7540eaadffcf7d4c7a3b702020-11-24T22:20:04ZengSEEdClinical Management Issues1973-48322283-31372018-10-0112110.7175/cmi.v12i1.13671258Statins and Immune-Mediated Necrotizing MyopathyMauro Turrin0Former Department of Internal Medicine, Ospedali Riuniti Padova Sud, Monselice (Padova), ItalyStatins are a well-recognized cause of a variety of skeletal myopathic effects, which generally resolve when discontinuing the treatment. Among autoimmune manifestations associated with statins, there is immune-mediated necrotizing myopathy (IMNM). The present article summarizes the main features of statin-related IMNM, describing diagnosis, classification, epidemiology, treatment, and the main autoantibodies detected. Statins are a well-recognized cause of a variety of skeletal myopathic effects, which generally resolve when discontinuing the treatment. Among autoimmune manifestations associated with statins, there is immune-mediated necrotizing myopathy (IMNM). The present article summarizes the main features of statin-related IMNM, describing diagnosis, classification, epidemiology, treatment, and the main autoantibodies detected. Although it is impossible to define the precise number, it evident that more than 550 statin-related IMNM cases have been described in the literature. Among IMNM, two forms must be distinguished: with anti-3-hydroxy-3-methylglutaryl-coenzyme A reductase (HMGCR) and with anti-signal recognition particle (SRP) antibodies. The differential diagnosis should be made between the IMNM and self-limited statin-related myopathy, drug-induced rhabdomyolysis, and nonautoimmune myopathies. Patients who have failed to normalize high creatine phosphokinase (CPK) after statin withdrawal should be tested for anti-HMGCR antibodies and, if these are positive, undergo muscle biopsy to confirm the diagnosis of IMNM. Pharmacological therapy of IMNM, not yet based on evidence, involves the use of high-dose corticosteroids, immunosuppressant drugs used alone or in combination, intravenous immunoglobulins (IVIg) or plasmapheresis.https://journals.seedmedicalpublishers.com/index.php/cmi/article/view/1367Hydroxymethylglutaryl-CoA Reductase InhibitorsDermatomyositisPolymyositisImmune-mediated necrotizing myopathyAnti-HMGCR antibodies |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Mauro Turrin |
spellingShingle |
Mauro Turrin Statins and Immune-Mediated Necrotizing Myopathy Clinical Management Issues Hydroxymethylglutaryl-CoA Reductase Inhibitors Dermatomyositis Polymyositis Immune-mediated necrotizing myopathy Anti-HMGCR antibodies |
author_facet |
Mauro Turrin |
author_sort |
Mauro Turrin |
title |
Statins and Immune-Mediated Necrotizing Myopathy |
title_short |
Statins and Immune-Mediated Necrotizing Myopathy |
title_full |
Statins and Immune-Mediated Necrotizing Myopathy |
title_fullStr |
Statins and Immune-Mediated Necrotizing Myopathy |
title_full_unstemmed |
Statins and Immune-Mediated Necrotizing Myopathy |
title_sort |
statins and immune-mediated necrotizing myopathy |
publisher |
SEEd |
series |
Clinical Management Issues |
issn |
1973-4832 2283-3137 |
publishDate |
2018-10-01 |
description |
Statins are a well-recognized cause of a variety of skeletal myopathic effects, which generally resolve when discontinuing the treatment. Among autoimmune manifestations associated with statins, there is immune-mediated necrotizing myopathy (IMNM).
The present article summarizes the main features of statin-related IMNM, describing diagnosis, classification, epidemiology, treatment, and the main autoantibodies detected.
Statins are a well-recognized cause of a variety of skeletal myopathic effects, which generally resolve when discontinuing the treatment. Among autoimmune manifestations associated with statins, there is immune-mediated necrotizing myopathy (IMNM).
The present article summarizes the main features of statin-related IMNM, describing diagnosis, classification, epidemiology, treatment, and the main autoantibodies detected.
Although it is impossible to define the precise number, it evident that more than 550 statin-related IMNM cases have been described in the literature. Among IMNM, two forms must be distinguished: with anti-3-hydroxy-3-methylglutaryl-coenzyme A reductase (HMGCR) and with anti-signal recognition particle (SRP) antibodies. The differential diagnosis should be made between the IMNM and self-limited statin-related myopathy, drug-induced rhabdomyolysis, and nonautoimmune myopathies.
Patients who have failed to normalize high creatine phosphokinase (CPK) after statin withdrawal should be tested for anti-HMGCR antibodies and, if these are positive, undergo muscle biopsy to confirm the diagnosis of IMNM. Pharmacological therapy of IMNM, not yet based on evidence, involves the use of high-dose corticosteroids, immunosuppressant drugs used alone or in combination, intravenous immunoglobulins (IVIg) or plasmapheresis. |
topic |
Hydroxymethylglutaryl-CoA Reductase Inhibitors Dermatomyositis Polymyositis Immune-mediated necrotizing myopathy Anti-HMGCR antibodies |
url |
https://journals.seedmedicalpublishers.com/index.php/cmi/article/view/1367 |
work_keys_str_mv |
AT mauroturrin statinsandimmunemediatednecrotizingmyopathy |
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