由抗3-羟基-3-甲基戊二酰辅酶A还原酶抗体相关坏死性自身免疫性肌病引起的孤立性臀肌和椎旁肌无力。
Isolated gluteal and paravertebral muscle weakness due to anti-3-hydroxy-3-methylglutaryl-coenzyme a reductase antibody-associated necrotizing autoimmune myopathy.
作者信息
McGrath Nicole M, Turner Clinton P
机构信息
Department of Medicine, Whangarei Hospital, Private Bag 9742, Whangarei, 0112, New Zealand.
Department of Anatomical Pathology, Auckland, New Zealand.
出版信息
Muscle Nerve. 2016 Jun;54(1):150-152. doi: 10.1002/mus.25130. Epub 2016 May 26.
INTRODUCTION
A 56-year-old man with a distant history of statin use presented with progressive isolated very proximal lower limb and truncal weakness. Electromyogram (EMG) showed isolated gluteal and lumbar paraspinal muscle involvement.
METHODS
Gluteus medius muscle biopsy was performed under general anesthesia.
RESULTS
The biopsy showed a pauci-inflammatory necrotizing myopathy. Serum antibodies to 3-hydroxy-3-methylglutaryl-coenzyme A reductase (HMGCR) were positive. He has since partially responded to corticosteroids and methotrexate.
CONCLUSIONS
Anti-HMGCR-associated necrotizing autoimmune myopathy (NAM) can present in a restricted form after cessation of a statin. Biopsy of a symptomatic but uncommonly studied muscle is worthwhile. Muscle Nerve 54: 150-152, 2016.
引言
一名有他汀类药物使用史的56岁男性出现进行性孤立性下肢近端和躯干肌无力。肌电图（EMG）显示仅臀肌和腰段椎旁肌受累。
方法
在全身麻醉下进行臀中肌活检。
结果
活检显示为少炎性坏死性肌病。血清3-羟基-3-甲基戊二酰辅酶A还原酶（HMGCR）抗体阳性。此后他对皮质类固醇和甲氨蝶呤有部分反应。
结论
抗HMGCR相关坏死性自身免疫性肌病（NAM）在停用他汀类药物后可呈局限性表现。对有症状但较少研究的肌肉进行活检是有价值的。《肌肉与神经》54: 150 - 152, 2016年。
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