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Isolated gluteal and paravertebral muscle weakness due to anti‐3‐hydroxy‐3‐methylglutaryl‐coenzyme a reductase antibody–associated necrotizing autoimmune myopathy
Author(s) -
McGrath Nicole M.,
Turner Clinton P.
Publication year - 2016
Publication title -
muscle and nerve
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.025
H-Index - 145
eISSN - 1097-4598
pISSN - 0148-639X
DOI - 10.1002/mus.25130
Subject(s) - medicine , muscle biopsy , myopathy , weakness , gluteal muscles , mitochondrial myopathy , biopsy , inflammatory myopathy , electromyography , muscle weakness , statin , lumbar , methotrexate , surgery , gastroenterology , endocrinology , biology , biochemistry , psychiatry , mitochondrial dna , gene
: A 56‐year‐old man with a distant history of statin use presented with progressive isolated very proximal lower limb and truncal weakness. Electromyogram (EMG) showed isolated gluteal and lumbar paraspinal muscle involvement. Methods : Gluteus medius muscle biopsy was performed under general anesthesia. Results : The biopsy showed a pauci‐inflammatory necrotizing myopathy. Serum antibodies to 3‐hydroxy‐3‐methylglutaryl‐coenzyme A reductase (HMGCR) were positive. He has since partially responded to corticosteroids and methotrexate. Conclusions : Anti‐HMGCR–associated necrotizing autoimmune myopathy (NAM) can present in a restricted form after cessation of a statin. Biopsy of a symptomatic but uncommonly studied muscle is worthwhile. Muscle Nerve 54 : 150–152, 2016