Chronic Onset Form of Anti-HMG-CoA Reductase Myopathy

Noel Lorenzo-Villalba; Emmanuel Andrès; Alain Meyer

doi:10.12890/2021_002672

Chronic Onset Form of Anti-HMG-CoA Reductase Myopathy

Eur J Case Rep Intern Med. 2021 Jun 8;8(7):002672. doi: 10.12890/2021_002672. eCollection 2021.

Authors

Noel Lorenzo-Villalba¹, Emmanuel Andrès¹, Alain Meyer²

Affiliations

¹ Service de Médecine Interne, Diabète et Maladies Métaboliques, Hôpitaux Universitaires de Strasboug, France.
² Service de Rhumatologie, Hôpitaux Universitaires de Strasbourg, France.

Abstract

We report a case of anti-HMGCR myopathy mimicking limb-girdle muscular dystrophy in a 27-year-old male patient with no history of statin intake and presenting with a chronic onset form over 3 years. Treatment with prednisone and methotrexate was initiated with an insufficient response, so intravenous immunoglobulin was added. One year after initial treatment was started, as levels of creatine kinase (CK) were >1000 U/l, treatment with rituximab was added. Despite a 3-year delay before treatment, muscle strength improved even though CK levels remain elevated.

Learning points: We describe a case of anti-HMGCR myopathy mimicking limb-girdle muscular dystrophy, which resulted in delayed diagnosis and management.The patient's muscular strength improved but creatine kinase levels remain elevated despite comprehensive treatment.

Keywords: Anti-HMG-CoA reductase; myopathy.