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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| Format: | Article |
| Language: | English |
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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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| author | Monique Crawford Xiaoshan Gong Johnny M. Trinh Sachin Chaudhary |
| author_facet | Monique Crawford Xiaoshan Gong Johnny M. Trinh Sachin Chaudhary |
| author_sort | Monique Crawford |
| collection | DOAJ |
| description | 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. |
| format | Article |
| id | doaj-art-691a472de6424a1c88a1a3d4bb7c58b4 |
| institution | Kabale University |
| issn | 2767-7664 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | American College of Physicians |
| record_format | Article |
| series | Annals of Internal Medicine: Clinical Cases |
| spelling | doaj-art-691a472de6424a1c88a1a3d4bb7c58b42025-08-20T03:45:41ZengAmerican College of PhysiciansAnnals of Internal Medicine: Clinical Cases2767-76642025-06-014610.7326/aimcc.2024.1120A Case Report of Anti–3-Hydroxy-3-Methylglutaryl-Coenzyme A Reductase Immune-Mediated Necrotizing MyopathyMonique Crawford0Xiaoshan Gong1Johnny M. Trinh2Sachin Chaudhary31School of Medicine, The University of Utah, Salt Lake City, Utah2College of Medicine, The University of Arizona, Tucson, Arizona2College of Medicine, The University of Arizona, Tucson, Arizona3Department of Medicine, Division of Pulmonary, Allergy, Critical Care & Sleep Medicine, The University of Arizona, Tucson, ArizonaWe 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.https://www.acpjournals.org/doi/10.7326/aimcc.2024.1120 |
| spellingShingle | Monique Crawford Xiaoshan Gong Johnny M. Trinh Sachin Chaudhary A Case Report of Anti–3-Hydroxy-3-Methylglutaryl-Coenzyme A Reductase Immune-Mediated Necrotizing Myopathy Annals of Internal Medicine: Clinical Cases |
| title | A Case Report of Anti–3-Hydroxy-3-Methylglutaryl-Coenzyme A Reductase Immune-Mediated Necrotizing Myopathy |
| title_full | A Case Report of Anti–3-Hydroxy-3-Methylglutaryl-Coenzyme A Reductase Immune-Mediated Necrotizing Myopathy |
| title_fullStr | A Case Report of Anti–3-Hydroxy-3-Methylglutaryl-Coenzyme A Reductase Immune-Mediated Necrotizing Myopathy |
| title_full_unstemmed | A Case Report of Anti–3-Hydroxy-3-Methylglutaryl-Coenzyme A Reductase Immune-Mediated Necrotizing Myopathy |
| title_short | A Case Report of Anti–3-Hydroxy-3-Methylglutaryl-Coenzyme A Reductase Immune-Mediated Necrotizing Myopathy |
| title_sort | case report of anti 3 hydroxy 3 methylglutaryl coenzyme a reductase immune mediated necrotizing myopathy |
| url | https://www.acpjournals.org/doi/10.7326/aimcc.2024.1120 |
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