title: Identifying statin-associated autoimmune necrotizing myopathy.
abstract: Statins up-regulate expression of 3-hydroxy-3-methylglutaryl coenzyme A reductase (HMGCR), the rate-limiting enzyme in cholesterol synthesis and the major target of autoantibodies in statin-associated immune-mediated necrotizing myopathy. As muscle cells regenerate, they express high levels of HMGCR, which may sustain the immune response even after statin therapy is stopped. Awareness of this entity will help physicians who prescribe statins to take action to limit the associated morbidity.
authors.affiliation: Division of Rheumatology, Department of Medicine, and Instructor in Medicine, Johns Hopkins University School of Medicine, Baltimore, MD.
authors.forename: Jemima
authors.initials: J
authors.lastname: Albayda
authors.affiliation: Director, Johns Hopkins Myositis Center, Division of Rheumatology, and Associate Professor, Johns Hopkins University School of Medicine, Baltimore, MD lchrist4@jhmi.edu.
authors.forename: Lisa
authors.initials: L
authors.lastname: Christopher-Stine
mesh_terms: D001323:Autoantibodies / Q000276:immunology; D001327:Autoimmune Diseases / Q000139:chemically induced* / Q000276:immunology / Q000473:pathology; D006801:Humans; D006903:Hydroxymethylglutaryl CoA Reductases / Q000187:drug effects / Q000276:immunology*; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000009:adverse effects*; D018482:Muscle, Skeletal / Q000187:drug effects / Q000276:immunology / Q000473:pathology; D009135:Muscular Diseases / Q000139:chemically induced* / Q000276:immunology / Q000473:pathology; D009336:Necrosis; D015854:Up-Regulation / Q000187:drug effects
chemical_list: D001323:Autoantibodies; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; C553220:HMGCR protein, human; D006903:Hydroxymethylglutaryl CoA Reductases