Italian 
English Il laboratorio di autoimmunità nella diagnosi di miopatia autoimmune necrotizzante indotta da statina
The autoimmunity laboratory in the diagnosis of necrotizing autoimmune myopathy induced by statins
AUTORI
Dipartimento Interaziendale di Medicina di Laboratorio e Anatomia Patologica ad Attività Integrata, Ospedale Civile di Baggiovara, AUSL Modena
Questo lavoro è stato in parte presentato al 52° Congresso Nazionale SIBioC, 6-8 Ottobre 2020, Virtual Edition, nella Sessione Casi Clinici
ABSTRACT
The autoimmunity laboratory in the diagnosis of necrotizing autoimmune myopathy induced by statins
Statins have been recently associated with a necrotizing autoimmune myopathy (NAM) characterized by inflammation, myopathy and muscle necrosis and by the presence of anti 3-hydroxy-3-methylglutaryl-coenzim A reductase antibodies (anti-HMGCR). This case report describes a case of a man who was taking atorvastatin, complaining muscle weakness and creatine kinase (CK) very high levels. The main laboratory and autoimmunity tests (including the major myositis antibodies) were negative, despite a muscle biopsy showed a myopathic process. Because of these results the detection of anti-HMGCR antibody was activated and the positive result confirmed the diagnosis of NAM. The patient stopped the statin therapy and started a steroid therapy with improvement in muscle symptoms and mild decrease of CK. The role of the autoimmunity laboratory in the diagnostic path of this rare autoimmune disease is fundamental. Though statin-associated NAM is a rare entity, it should be considered in patients who continue to have CK elevation and muscle weakness during or after discontinuation of statin therapy.