他汀类药物诱导的坏死性自身免疫性肌病和自身免疫性肝炎伴吞咽困难。
Statin-induced necrotising autoimmune myopathy and autoimmune hepatitis presenting with dysphagia.
作者信息
Qasim Agha Osama, Kaur Sukhdeep, Vijayavel Nirmal
机构信息
Department of Internal Medicine, St. Jospeh's Hospital and Medical Center, Phoenix, Arizona, USA
Department of Internal Medicine, Creighton University School of Medicine, Phoenix, Arizona, USA.
出版信息
BMJ Case Rep. 2020 Feb 5;13(2):e232391. doi: 10.1136/bcr-2019-232391.
Statin-induced necrotising autoimmune myopathy (SINAM) is a rare disease characterised by proximal muscle weakness and elevated creatine kinase levels that is usually in the thousands. Anti-3-hydroxy-3-methyl glutaryl co-enzyme A reductase (HMGCR) antibodies are associated with SINAM. Autoimmune hepatitis (AIH) is an inflammatory disease of the liver that is usually of unknown aetiology but can also be associated with concurrent extrahepatic autoimmune disorders. We are reporting a case of biopsy proven AIH associated with SINAM in a patient presenting with oropharyngeal dysphagia. The patient had elevated anti-HMGCR antibodies and anti-smooth muscle antibodies. SINAM and AIH were confirmed by muscle biopsy and liver biopsy, respectively. The patient had complete resolution of his symptoms and complete normalisation of his liver function tests after 6 months of the treatment.
他汀类药物诱导的坏死性自身免疫性肌病（SINAM）是一种罕见疾病，其特征为近端肌无力和肌酸激酶水平升高，通常可达数千。抗3-羟基-3-甲基戊二酰辅酶A还原酶（HMGCR）抗体与SINAM相关。自身免疫性肝炎（AIH）是一种肝脏炎症性疾病，病因通常不明，但也可能与并发的肝外自身免疫性疾病有关。我们报告一例经活检证实的AIH合并SINAM的病例，该患者表现为口咽吞咽困难。患者抗HMGCR抗体和抗平滑肌抗体升高。分别通过肌肉活检和肝活检确诊为SINAM和AIH。经过6个月的治疗，患者症状完全缓解，肝功能检查完全恢复正常。
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