A Case Report of Anti–3-Hydroxy-3-Methylglutaryl-Coenzyme A Reductase Immune-Mediated Necrotizing Myopathy
We present a 75-year-old woman with 3 months of progressive proximal muscle weakness, myalgias, and dysphagia. Her admission was complicated by acute hypoxic respiratory failure requiring admission to the intensive care unit. Her clinical presentation and laboratory investigations were consistent wi...
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| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
| Published: |
American College of Physicians
2025-06-01
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| Series: | Annals of Internal Medicine: Clinical Cases |
| Online Access: | https://www.acpjournals.org/doi/10.7326/aimcc.2024.1120 |
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| Summary: | We present a 75-year-old woman with 3 months of progressive proximal muscle weakness, myalgias, and dysphagia. Her admission was complicated by acute hypoxic respiratory failure requiring admission to the intensive care unit. Her clinical presentation and laboratory investigations were consistent with typical and atypical signs and symptoms of anti–3-hydroxy-3-methylglutaryl-coenzyme A reductase (HMGCR) immune-mediated necrotizing myopathy (IMNM). Treatment with intravenous immunoglobulin, intravenous methylprednisolone, and oral methotrexate provided immediate relief of symptoms, further supporting the diagnosis of anti-HMGCR IMNM. We discuss the atypical presentations of anti-HMGCR IMNM and the complication of bulbar involvement leading to respiratory failure. |
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| ISSN: | 2767-7664 |