Author:
Gagliardo Carola Maria,Noto Davide,Giammanco Antonina,Maltese Silvia,Vecchio Luca,Lavatura Giuseppe,Cacciatore Valentina,Barbagallo Carlo Maria,Ganci Antonina,Nardi Emilio,Ciaccio Marcello,Lo Presti Rosalia,Cefalù Angelo Baldassare,Averna Maurizio
Abstract
AbstractStatin-induced autoimmune myositis (SIAM) represents a rare clinical entity that can be triggered by prolonged statin treatment. Its pathogenetic substrate consists of an autoimmune-mediated mechanism, evidenced by the detection of antibodies directed against the 3-hydroxy-3-methylglutaryl-coenzyme A reductase (anti-HMGCR Ab), the target enzyme of statin therapies. To facilitate the diagnosis of nuanced SIAM clinical cases, the present study proposes an “experience-based” diagnostic algorithm for SIAM. We have analyzed the clinical data of 69 patients diagnosed with SIAM. Sixty-seven patients have been collected from the 55 available and complete case records regarding SIAM in the literature; the other 2 patients represent our direct clinical experience and their case records have been detailed. From the analysis of the clinical features of 69 patients, we have constructed the diagnostic algorithm, which starts from the recognition of suggestive symptoms of SIAM. Further steps provide for CK values dosage, musculoskeletal MR, EMG/ENG of upper-lower limbs and, Anti-HMGCR Ab testing and, where possible, the muscle biopsy. A global evaluation of the collected clinical features may suggest a more severe disease in female patients. Atorvastatin proved to be the most used hypolipidemic therapy.
Funder
Università degli Studi di Palermo
Publisher
Springer Science and Business Media LLC
Subject
Emergency Medicine,Internal Medicine
Cited by
1 articles.
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1. Multiple drugs;Reactions Weekly;2023-09-02