Necrotizing Autoimmune Myopathy

In a new review of NAM cases, half were idiopathic and statins, cancer, and connective tissue disease were risk factors. Researchers recommend intravenous…

Saving the worst for last, the necrotizing myopathies can result in rapid muscle loss, requiring prolonged and difficult rehabilitation. The destructive mayhem can sometimes occur in the absence of overt autoimmune inflammatory cells infiltrating the muscle tissue, hence the moniker “myopathy” rather than “myositis”.

Widespread Muscle Involvement in Necrotizing Myopathy

Findings indicate immune-mediated necrotizing myopathy is a ‘unique form of myositis’

This article outlines the importance of distinguishing between different forms of myopathies, including nectrotizing myopathy.

Anti-SRP (Signal Recognition Particle) stands out amongst the group of newly recognised autoantibodies implicated in the worst subset of immune-mediated inflammatory myopathies.
It’s presence warrants closer monitoring and possibly more aggressive immunosuppression.

Necrotising autoimmune myopathy requires early, aggressive treatment

Researchers call for the prompt recognition of necrotising autoimmune myopathy and aggressive early treatment with a combination of intravenous immune…

Can we predict the likelihood of developing statin myopathy in an individual patient?

Statin use in the treatment of dyslipidaemia to reduce cardiovascular risk is widespread. Muscle enzymes elevation in the context of statin use is not uncommon, but symptomatic myopathy (muscular pain and weakness) with very high levels of serum CK is rare.
Sometimes, the myopathy/myositis persists even long after the statin had been withdrawn. Current thought is that statin-induced necrotizing myopathy is autoimmune-mediated, and thus may require immunosuppression in addition to statin withdrawal.

Statin-induced necrotizing myopathy is associated with autoantibodies targeting the same enzyme that statins inhibit to reduce LDL: 3-hydroxy-3-methylglutaryl-coenzyme A reductase (HMGCR).
The autoantibodies are probably not pathogenic, but merely indicative of the underlying immune disorder. The pathogenic mechanism is under investigation.