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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 Medicine+(Baltimore)
2014 ; 93
(3
): 150-157
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English Wikipedia
Anti-HMGCR autoantibodies in European patients with autoimmune necrotizing
myopathies: inconstant exposure to statin
#MMPMID24797170
Allenbach Y
; Drouot L
; Rigolet A
; Charuel JL
; Jouen F
; Romero NB
; Maisonobe T
; Dubourg O
; Behin A
; Laforet P
; Stojkovic T
; Eymard B
; Costedoat-Chalumeau N
; Campana-Salort E
; Tournadre A
; Musset L
; Bader-Meunier B
; Kone-Paut I
; Sibilia J
; Servais L
; Fain O
; Larroche C
; Diot E
; Terrier B
; De Paz R
; Dossier A
; Menard D
; Morati C
; Roux M
; Ferrer X
; Martinet J
; Besnard S
; Bellance R
; Cacoub P
; Arnaud L
; Grosbois B
; Herson S
; Boyer O
; Benveniste O
Medicine (Baltimore)
2014[May]; 93
(3
): 150-157
PMID24797170
show ga
Necrotizing autoimmune myopathy (NAM) is a group of acquired myopathies
characterized by prominent myofiber necrosis with little or no muscle
inflammation. Recently, researchers identified autoantibodies (aAb) against
3-hydroxy-3-methylglutaryl-coenzyme A reductase (HMGCR) in patients with NAM,
especially in statin-exposed patients. Here we report what is to our knowledge
the first European cohort of patients with NAM.The serum of 206 patients with
suspicion of NAM was tested for detection of anti-HMGCR aAb using an addressable
laser bead immunoassay. Forty-five patients were found to be anti-HMGCR positive.
Their mean age was 48.9 ± 21.9 years and the group was predominantly female
(73.3%). Statin exposure was recorded in 44.4% of patients. Almost all patients
had a muscular deficit (97.7%), frequently severe (Medical Research Council [MRC]
5 ?3 in 75.5%). Subacute onset (<6 mo) was noted for most of them (64.4%).
Nevertheless, 3 patients (6.6%) had a slowly progressive course over more than 10
years. Except for weight loss (20%), no extramuscular sign was observed. The mean
CK level was high (6941 ± 8802 IU/L) and correlated with muscle strength
evaluated by manual muscle testing (r = -0.37, p = 0.03). Similarly, anti-HMGCR
aAb titers were correlated with muscular strength (r = -0.31; p = 0.03) and CK
level (r = 0.45; p = 0.01). Mean duration of treatment was 34.1 ± 40.8 months,
and by the end of the study no patient had been able to stop treatment.This study
confirms the observation and description of anti-HMGCR aAb associated with NAM.
The majority of patients were statin naive and needed prolonged treatments. Some
patients had a dystrophic-like presentation. Anti-HMGR aAb titers correlated with
CK levels and muscle strength, suggesting their pathogenic role.