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Case Reports
. 2022 Jul;43(7):4567-4570.
doi: 10.1007/s10072-022-06046-3. Epub 2022 Apr 7.

A case of anti-HMGCR myopathy triggered by sodium/glucose co-transporter 2 (SGLT2) inhibitors

Manuela Stella #  1   2 , Erica Biassoni #  3   4   5 , Chiara Fiorillo  4   6 , Marina Grandis  4   5 , Francesca Mattioli  7   8 , Massimo Del Sette  5
Affiliations
Case Reports

A case of anti-HMGCR myopathy triggered by sodium/glucose co-transporter 2 (SGLT2) inhibitors

Manuela Stella et al. Neurol Sci. 2022 Jul.

Abstract

Inflammatory myopathies, including immune-mediated necrotizing myopathy (IMNM), are a rare and heterogeneous group of autoimmune diseases which can even involve extramuscular districts and seriously impact patients' quality of life. We report the case of a 76-year-old woman who developed muscle weakness, fatigue, and increased CK, following treatment with dapagliflozin, a sodium/glucose co-transporter 2 (SGLT2) inhibitor, and metformin. Neurophysiology, muscle biopsy, and antibody dosage confirmed the diagnosis of IMNM. The temporal correlation between the onset of clinical manifestations and the increase in the dosage of antidiabetic drugs, the improvement of symptoms with the dechallenge of dapagliflozin, and the exclusion of other possible causes triggering myopathy suggests that this may be the first case of dapagliflozin-induced myopathy, different from the former one associated with the use of SGLT2 inhibitors.

Keywords: Anti-HMGCR antibodies; Dapagliflozin; Drug-induced myopathy; IMNM.

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