Intravenous Immune Globulin for Statin-Triggered Autoimmune Myopathy

Although most statin-related myopathy is self-limited, in rare cases statins trigger autoimmune myopathy, which requires control with immunosuppressive therapy. Three patients with this disorder were treated with intravenous immunoglobulin as initial therapy, with some benefit. To the Editor: Although treatment with statins may cause muscle-related symptoms in 10 to 20% of patients, these symptoms usually resolve within weeks after the medication is stopped. In rare instances, however, the medication causes statin-triggered autoimmune myopathy, a condition characterized by proximal muscle weakness, prominent necrosis of muscle fibers (detected on biopsy), elevated serum levels of creatine kinase, and the presence of autoantibodies that recognize 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase, the pharmacologic target of statins. 1 – 3 Moreover, statin-triggered autoimmune myopathy progresses despite the discontinuation of statins and requires control with immunosuppressive therapy. No clinical trials have been conducted to . . .