title: Immune-mediated statin myopathy.
abstract: Statin-induced necrotizing autoimmune myopathy (SINAM) is associated with a unique clinical 5 phenotype of severe proximal muscle weakness during or after exposure to statins in patients with high creatine kinase (CK) levels. Electromyography (EMG) and muscle biopsy reveal features of a necrotizing myopathy and the anti-HMGCR autoantibody is frequently detected. Treatment requires a combination of statin discontinuation as well as immunomodulatory or immunosuppressive therapy. HLA typing (HLADRB1*1101) is strongly associated with anti-10 HMGCR autoantibody positivity in statin-exposed patients. It is well documented that statin triggers autoimmune disease in those with a genetic susceptibility. With the commercial availability of an accurate ELISA test, the natural history of the disease and its phenotypic features are becoming increasingly understood.
authors.affiliation: a Division of Rheumatology and Clinical Immunology, Department of Medicine , University of Pittsburgh , Pittsburgh , PA , USA.
authors.forename: Priyadarshini
authors.initials: P
authors.lastname: Loganathan
authors.affiliation: a Division of Rheumatology and Clinical Immunology, Department of Medicine , University of Pittsburgh , Pittsburgh , PA , USA.
authors.forename: Chester V
authors.initials: CV
authors.lastname: Oddis
authors.affiliation: a Division of Rheumatology and Clinical Immunology, Department of Medicine , University of Pittsburgh , Pittsburgh , PA , USA.
authors.forename: Rohit
authors.initials: R
authors.lastname: Aggarwal
mesh_terms: D000906:Antibodies / Q000378:metabolism; D001327:Autoimmune Diseases / Q000139:chemically induced / Q000188:drug therapy / Q000276:immunology*; D020022:Genetic Predisposition to Disease; D006680:HLA Antigens / Q000235:genetics; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000009:adverse effects / Q000276:immunology / Q000627:therapeutic use*; D007159:Immunologic Tests; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D009135:Muscular Diseases / Q000139:chemically induced / Q000188:drug therapy / Q000276:immunology*; D011110:Polymorphism, Genetic
chemical_list: D000906:Antibodies; D006680:HLA Antigens; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D007166:Immunosuppressive Agents
keywords: anti HMGCR antibody; autoimmune; hydroxy-methyl-glutaryl-Co-A reductase; necrotizing myopathy; statin