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Statin induced necrotizing autoimmune myopathy.
J Neurol Sci. 2015 Apr 15; 351(1-2):13-17.JN

Abstract

Statin induced necrotizing autoimmune myopathy (SINAM) is a recently characterized entity belonging to the spectrum of statin myotoxicity. It is a more severe form, and is usually associated with significant proximal muscle weakness, strikingly elevated creatine kinase levels and persistent symptoms despite statin discontinuation. The characteristic pathological finding is a marked muscle fiber necrosis with minimal or no inflammation on muscle biopsy. SINAM is an autoimmune disorder associated with an antibody against 3-hydroxy-3-methyglutaryl-coenzyme A reductase (HMGCR), and the antibody titer is a useful marker for assessing treatment response. However, anti-HMGCR positive myopathies are also caused by unknown etiologies other than statin exposure, especially in the younger population. SINAM should be promptly recognized as immunosuppressive therapy can improve its clinical outcome significantly. Further research is needed to elucidate its pathogenesis and provide evidence based guidelines for management.

Authors+Show Affiliations

Neuromuscular Center, Department of Neurology, Cleveland Clinic, OH, United States.Neuromuscular Center, Department of Neurology, Cleveland Clinic, OH, United States. Electronic address: liy@ccf.org.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

25765229

Citation

Babu, Suma, and Yuebing Li. "Statin Induced Necrotizing Autoimmune Myopathy." Journal of the Neurological Sciences, vol. 351, no. 1-2, 2015, pp. 13-17.
Babu S, Li Y. Statin induced necrotizing autoimmune myopathy. J Neurol Sci. 2015;351(1-2):13-17.
Babu, S., & Li, Y. (2015). Statin induced necrotizing autoimmune myopathy. Journal of the Neurological Sciences, 351(1-2), 13-17. https://doi.org/10.1016/j.jns.2015.02.042
Babu S, Li Y. Statin Induced Necrotizing Autoimmune Myopathy. J Neurol Sci. 2015 Apr 15;351(1-2):13-17. PubMed PMID: 25765229.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Statin induced necrotizing autoimmune myopathy. AU - Babu,Suma, AU - Li,Yuebing, Y1 - 2015/03/03/ PY - 2014/12/05/received PY - 2015/02/07/revised PY - 2015/02/24/accepted PY - 2015/3/14/entrez PY - 2015/3/15/pubmed PY - 2016/1/12/medline KW - HMGCR antibody KW - Immunosuppression KW - Myopathy KW - Necrotizing autoimmune myopathy KW - Statin KW - Statin myotoxicity SP - 13 EP - 17 JF - Journal of the neurological sciences JO - J Neurol Sci VL - 351 IS - 1-2 N2 - Statin induced necrotizing autoimmune myopathy (SINAM) is a recently characterized entity belonging to the spectrum of statin myotoxicity. It is a more severe form, and is usually associated with significant proximal muscle weakness, strikingly elevated creatine kinase levels and persistent symptoms despite statin discontinuation. The characteristic pathological finding is a marked muscle fiber necrosis with minimal or no inflammation on muscle biopsy. SINAM is an autoimmune disorder associated with an antibody against 3-hydroxy-3-methyglutaryl-coenzyme A reductase (HMGCR), and the antibody titer is a useful marker for assessing treatment response. However, anti-HMGCR positive myopathies are also caused by unknown etiologies other than statin exposure, especially in the younger population. SINAM should be promptly recognized as immunosuppressive therapy can improve its clinical outcome significantly. Further research is needed to elucidate its pathogenesis and provide evidence based guidelines for management. SN - 1878-5883 UR - https://www.unboundmedicine.com/medline/citation/25765229/Statin_induced_necrotizing_autoimmune_myopathy_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0022-510X(15)00122-7 DB - PRIME DP - Unbound Medicine ER -