Detailed Information on Publication Record
2017
Statiny indukovaná nekrotizující autoimunitní myopatie
HORÁK, Tomáš, Stanislav VOHÁŇKA, Eliška TVRDÍKOVÁ, Magda HORÁKOVÁ, Josef BEDNAŘÍK et. al.Basic information
Original name
Statiny indukovaná nekrotizující autoimunitní myopatie
Name (in English)
Statin-induced Necrotizing Autoimmune Myopathy
Authors
HORÁK, Tomáš (203 Czech Republic, guarantor, belonging to the institution), Stanislav VOHÁŇKA (203 Czech Republic, belonging to the institution), Eliška TVRDÍKOVÁ (203 Czech Republic, belonging to the institution), Magda HORÁKOVÁ (203 Czech Republic, belonging to the institution) and Josef BEDNAŘÍK (203 Czech Republic, belonging to the institution)
Edition
Ceska a slovenska neurologie a neurochirurgie, Praha, Nakladatelské a tiskové středisko ČLS JEP, 2017, 1210-7859
Other information
Language
Czech
Type of outcome
Článek v odborném periodiku
Field of Study
30103 Neurosciences
Country of publisher
Czech Republic
Confidentiality degree
není předmětem státního či obchodního tajemství
Impact factor
Impact factor: 0.508
RIV identification code
RIV/00216224:14110/17:00098483
Organization unit
Faculty of Medicine
UT WoS
000412370300009
Keywords in English
myopathy; statins; autoimmunity; necrosis; autoantibodies; anti-HMGCR
Tags
Tags
International impact, Reviewed
Změněno: 20/3/2018 14:18, Soňa Böhmová
V originále
Léčba statiny může být ve vzácných případech asociována s tvorbou specifických autoprotilátek proti 3-hydroxy-3-metylglutaryl koenzym A reduktáze (anti-HMGCR), pletencovou svalovou slabostí, zvýšenou hladinou kreatinkinázy (CK) a nekrózou myofibril ve svalové biopsii. Přítomnost těchto znaků tvoří hlavní kritéria nově definované nozologické jednotky označované jako statiny indukovaná nekrotizující myopatie (Statin Induced Necrotizing Autoimmune Myopathy; SINAM). Předpokládaná autoimunitní etiopatogeneze opodstatňuje použití kombinované imunosupresivní terapie. Klinický průběh, diagnostická kritéria i terapeutická účinnost imunosupresivní léčby jsou u SINAM obdobné jako u imunitně zprostředkované nekrotizující myopatie (Immune Mediated Necrotizing Myopathy; IMNM) bez asociace s léčbou statiny.
In English
Aim: Statin therapy might be rarely associated with production of specific autoantibodies against 3-hydroxy-3-methylglutaryl coenzyme A reductase (anti-HMGCR), proximal muscle weakness, high creatine kinase (CK) levels and myofibril necrosis in muscle biopsy. Presence of these symptoms established the main criteria of a new clinical unit called Statin Induced Necrotizing Autoimmune Myopathy (SINAM). Assumed autoimmune etiopathogenesis justifies the use of combined immunosuppressive therapy. Clinical course, diagnostic criteria and therapeutic efficacy of immunosuppressive treatment are similar to that of Immune Mediated Necrotizing Myopathy (IMNM) without association with statin therapy. Methods: The group of 7 SINAM patients was classified by reassessment of the diagnostic group of 30 patients diagnosed with autoimmune myopathies based on determination of anti-HMGCR antibodies, structured quantitative revision of muscle biopsies and detailed medical history (confirming chronic statin therapy). Results: In total 30 subjects with the original diagnosis dermatomyositis, polymyositis or IMNM were tested for HMGCR antibodies. Twelve patients out of them were anti-HMGCR positive (IMNM 5x, 7x PM) and 7 of them had been on statin therapy before the symptoms developed. These 7 patients were reclassified as SINAM. Myofibrillar necrosis was found in their muscle biopsies in all cases and 5 patients also had inflammatory cell infiltration. All these patients had significantly elevated CK levels (> 10 fold) at early stage of the disease. Combined immunosuppression led to remission of clinical symptoms and normalization or significant CK level drop in all patients.
Links
| MUNI/A/1072/2015, interní kód MU |
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