title: Update on toxic myopathies.
abstract: The toxic myopathies are a clinically and pathologically diverse group of disorders that can be caused by a variety of therapeutic agents used in clinical practice, as well as various venoms and other biological toxins. The most important iatrogenic causes are the statin and fibrate cholesterol-lowering agents that can cause a severe necrotizing myopathy and acute rhabdomyolysis and myoglobinuria. The current update focuses on the mechanisms of statin myotoxicity and the importance of genetic predisposing factors for statin myopathy, as well as the recently described form of necrotizing autoimmune myopathy, which is associated with antibodies to the 3-hydroxy-3-methylglutaryl-coenzyme A reductase enzyme and is responsive to aggressive immunotherapy. Mitochondrial myopathies associated with antiretroviral agents and the pyrimidine nucleoside analogue clevudine, and recent reports of myopathies caused by ingestion of red yeast rice and toxic species of mushrooms are also discussed.
authors.affiliation: Centre for Neurological and Neuromuscular Disorders, University of Western Australia, Australian Neuromuscular Research Institute, QEII Medical Centre, 4th Floor A Block, Verdun Street, Nedlands, WA, 6009, Australia. flmast@cyllene.uwa.edu.au
authors.forename: F L
authors.initials: FL
authors.lastname: Mastaglia
authors.forename: M
authors.initials: M
authors.lastname: Needham
mesh_terms: D000363:Agaricales; D001688:Biological Products / Q000009:adverse effects; D002986:Clinical Trials as Topic; D004347:Drug Interactions; D058607:Fibric Acids / Q000009:adverse effects; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000009:adverse effects; D009135:Muscular Diseases / Q000139:chemically induced* / Q000473:pathology / Q000503:physiopathology; D012206:Rhabdomyolysis / Q000139:chemically induced / Q000473:pathology; D012307:Risk Factors; D014688:Venoms / Q000633:toxicity
chemical_list: D001688:Biological Products; D058607:Fibric Acids; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D014688:Venoms; C117343:red yeast rice