ANCA-positive vasculitis associated with simvastatin/ezetimibe: expanding the spectrum of statin-induced autoimmunity?
Although autoimmune syndromes such as systemic lupus erythematosus and dermatomyositis have been previously reported in association with statin use, vasculitis has not been well described. We present a patient with an antineutrophil cytoplasmic antibody-positive, predominantly cutaneous vasculitis, the temporal course of which was associated with simvastatin/ezetimibe use. The patient's serologic findings were consistent with drug-induced disease, with high titer antimyeloperoxidase, in addition to antinuclear and anti-Ro (SSA) antibodies. The patient demonstrated complete resolution of symptoms simply by withdrawing the drug.
Sen
Deepali
D
Department of Medicine, Saint Barnabas Medical Center, Livingston, NJ 07039, USA.
Rosenstein
Elliot D
ED
Kramer
Neil
N
D056648:Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis / Q000139:chemically induced* / Q000276:immunology; D019268:Antibodies, Antineutrophil Cytoplasmic / Q000097:blood; D000924:Anticholesteremic Agents / Q000009:adverse effects*; D015551:Autoimmunity / Q000187:drug effects*; D001384:Azetidines / Q000009:adverse effects*; D015415:Biomarkers / Q000097:blood; D004338:Drug Combinations; D000069499:Ezetimibe, Simvastatin Drug Combination; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D009195:Peroxidase / Q000276:immunology; D012261:Ribonucleoproteins / Q000276:immunology; D019821:Simvastatin / Q000009:adverse effects*; D000099207:SS-A Antigen
D019268:Antibodies, Antineutrophil Cytoplasmic; D000924:Anticholesteremic Agents; D001384:Azetidines; D015415:Biomarkers; D004338:Drug Combinations; D000069499:Ezetimibe, Simvastatin Drug Combination; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D009195:Peroxidase; D012261:Ribonucleoproteins; D019821:Simvastatin; D000099207:SS-A Antigen