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Statins are amongst the most prescribed drugs worldwide and they are generally safe. A rare but potentially serious adverse effect of statins’ therapy has been described – anti-3-hydroxy-3-methyl-glutaryl-coenzyme A reductase (anti-HMGCR) immunemediated necrotizing myopathy (IMNM) – that can occur years after the drug has been started. We conducted a literature review after illustrating a typical case of anti-HMGCR IMNM. A 67-year-old female treated with simvastatin for the past 5 years presented with proximal myalgias and tetraparesis, raised creatine kinase, a myopathic pattern on electromyogram, a necrotizing myopathy on muscle biopsy and anti-HMGCR antibodies. The statin was stopped, and immunosuppressive therapy was commenced, leading to a complete remission. The distinction between anti-HMGCR IMNM and other myopathies is crucial, so that the appropriate treatment can be started promptly. Likewise, it is important that clinicians be aware of this entity.

Miopatia Imunomediada por Anticorpos Anti-HMGCR: Revisão da Literatura com Base num Caso Clínico