Statin-induced autoimmune necrotizing myopathy with pharyngeal muscles involvement. (7th March 2020)

• Record Type: Journal Article
• Authors: Mirlesse, Nicolas; Egervari, Kristof; Bornand, Aurélie; Lecluse, Julien; Lobrinus, Johannes A; Scheffler, Max; Serratrice, Christine; Prendki, Virginie; Cuvelier, Clémence
• Is Part Of: Age and ageing. Volume 49:Number 5(2020)
• Page Start: 883
• Page End: 884
• Publication Date: 2020-03-07
• Subjects: statins -- older patients -- anti-HMGCR necrotising myopathy -- dysphagia -- pharyngeal muscles necrosis; Aging -- Periodicals; Geriatrics -- Periodicals; 618.97
• DOI: 10.1093/ageing/afaa038
• Languages: English
• ISSNs: 0002-0729

Abstract

Abstract: Statins are widely prescribed in the treatment of hypercholesterolemia. While their efficacy in the secondary prevention of vascular events is proven, their safety profile in older patients with multiple co-morbidities and polypharmacy remains questionable. Although rare, antihydroxy-3-methylglutaryl-coenzyme A reductase (anti-HMGCR) myopathy is a severe adverse effect of statins, manifesting as myalgias, proximal muscle weakness, muscle cell necrosis and rhabdomyolysis. We report an uncommon case of an autopsy-proven anti-HMGCR necrotising myopathy predominately affecting pharyngeal muscles in an older patient, leading to dysphagia, pneumonia and death within 3 weeks from onset. Clinicians should screen for dysphagia in any patient with suspected anti-HMGCR myopathy, order an anti-HMGCR antibody titre and consider prompt immunosupressive therapy.