title: Absence of anti-HMG-CoA reductase autoantibodies in severe self-limited statin-related myopathy.
abstract: Patients with self-limited statin-related myopathy improve spontaneously when statins are stopped. In contrast, patients with statin-associated autoimmune myopathy have autoantibodies recognizing 3-hydroxy-3-methyl-glutaryl-coenzyme A reductase (HMGCR) and usually require immunosuppressive therapy to control their disease. On initial presentation, it can sometimes be difficult to distinguish between these 2 diseases, as both present with muscle pain, weakness, and elevated serum creatine kinase (CK) levels. The goal of this study was to determine whether patients with severe self-limited statin-related myopathy also make anti-HMGCR autoantibodies.
  
  
  
  We screened 101 subjects with severe self-limited cerivastatin-related myopathy for anti-HMGCR autoantibodies.
  
  
  
  No patient with severe self-limited cerivastatin-related myopathy had anti-HMGCR autoantibodies.
  
  
  
  Anti-HMGCR autoantibody testing can be used to help differentiate whether a patient has self-limited myopathy due to cerivastatin or autoimmune statin-associated myopathy; these findings may apply to other statins as well. Muscle Nerve 54: 142-144, 2016.
authors.affiliation: Department of Medicine, University of Washington, Seattle, Washington, USA.
authors.forename: James S
authors.initials: JS
authors.lastname: Floyd
authors.affiliation: Department of Medicine, University of Washington, Seattle, Washington, USA.
authors.forename: Jennifer A
authors.initials: JA
authors.lastname: Brody
authors.affiliation: Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
authors.forename: Eleni
authors.initials: E
authors.lastname: Tiniakou
authors.affiliation: Department of Medicine, University of Washington, Seattle, Washington, USA.|Department of Epidemiology, University of Washington, Seattle, Washington, USA.|Health Services, University of Washington, Seattle, Washington, USA.
authors.forename: Bruce M
authors.initials: BM
authors.lastname: Psaty
authors.affiliation: Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.|National Institutes of Health, Bethesda, Maryland, USA.
authors.forename: Andrew
authors.initials: A
authors.lastname: Mammen
mesh_terms: D000368:Aged; D001323:Autoantibodies / Q000378:metabolism*; D003402:Creatine Kinase / Q000097:blood; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000276:immunology* / Q000633:toxicity*; D008297:Male; D008875:Middle Aged; D009135:Muscular Diseases / Q000097:blood / Q000139:chemically induced* / Q000276:immunology*; D011725:Pyridines / Q000633:toxicity*; D012189:Retrospective Studies
chemical_list: D001323:Autoantibodies; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D011725:Pyridines; C086276:cerivastatin; D003402:Creatine Kinase
keywords: adverse drug reaction; autoimmune; myopathy; rhabdomyolysis; statins