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Case Reports
. 2022 Dec 12;33(4):342-349.
eCollection 2022 Dec.

Anti-HMGCR Myopathy without Exposure to Statins: A Case Report

Jorge Ferriz Vivancos  1 , Marta Fandos Sánchez  1 , Pilar Teresa Timoneda Timoneda  1 , Goitzane Marcaida Benito  1
Affiliations
Case Reports

Anti-HMGCR Myopathy without Exposure to Statins: A Case Report

Jorge Ferriz Vivancos et al. EJIFCC. .

Abstract

Anti-HMGCR, which was first identified in 2010, has emerged as an important mechanism of myopathogenesis in patients with exposure to statins. The availability of new detection methods has expanded the phenotypic spectrum with a subtype of population that hasn't been exposed to the drug and whose clinical, analytical, and pathological manifestations are similar. The observation by immunofluorescence of a highly specific pattern known as HALIP (HMGCR Associated Liver Immunofluorescence Pattern) can be useful in the detection of these antibodies.

Keywords: HALIP; elevated CK values; myopathy; statins.

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Conflict of interest statement

Conflict of interest: The authors have declared that no conflict of interest exists.

Figures

Figure 1
Figure 1
HALIP: pattern of immunofluorescence in the cytoplasm of hepatocytes with centro-lobular distribution (yellow arrow) in rat liver stain (dilution 1/80)
Figure 2
Figure 2
(I) Hematoxylin and eosin stain of muscle biopsy with necrotic and regenerative muscle fibers (orange arrow). (II) Immunostaining with sarcolemmal C5b–9 (MAC) deposits in necrotic fibers (red arrow)
Figure 3
Figure 3
CK levels (I) and anti-HMGCR levels (II) during follow-up after Urge Care (Day 1)
See this image and copyright information in PMC

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