Loganathan Priyadarshini, Oddis Chester V, Aggarwal Rohit
a Division of Rheumatology and Clinical Immunology, Department of Medicine , University of Pittsburgh , Pittsburgh , PA , USA.
Expert Rev Clin Immunol. 2016;12(1):33-8. doi: 10.1586/1744666X.2016.1103181. Epub 2015 Oct 30.
Statin-induced necrotizing autoimmune myopathy (SINAM) is associated with a unique clinical 5 phenotype of severe proximal muscle weakness during or after exposure to statins in patients with high creatine kinase (CK) levels. Electromyography (EMG) and muscle biopsy reveal features of a necrotizing myopathy and the anti-HMGCR autoantibody is frequently detected. Treatment requires a combination of statin discontinuation as well as immunomodulatory or immunosuppressive therapy. HLA typing (HLADRB1*1101) is strongly associated with anti-10 HMGCR autoantibody positivity in statin-exposed patients. It is well documented that statin triggers autoimmune disease in those with a genetic susceptibility. With the commercial availability of an accurate ELISA test, the natural history of the disease and its phenotypic features are becoming increasingly understood.
他汀类药物诱导的坏死性自身免疫性肌病（SINAM）与一种独特的临床表型相关，即在肌酸激酶（CK）水平升高的患者中，在接触他汀类药物期间或之后出现严重的近端肌无力。肌电图（EMG）和肌肉活检显示坏死性肌病的特征，并且经常检测到抗HMGCR自身抗体。治疗需要停用他汀类药物以及进行免疫调节或免疫抑制治疗。HLA分型（HLADRB1*1101）与他汀类药物暴露患者的抗HMGCR自身抗体阳性密切相关。有充分的文献记载，他汀类药物会在具有遗传易感性的人群中引发自身免疫性疾病。随着准确的ELISA检测方法的商业化应用，该疾病的自然史及其表型特征越来越为人所知。
