{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,5]],"date-time":"2025-11-05T06:28:57Z","timestamp":1762324137320,"version":"3.37.3"},"reference-count":30,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2018,1,3]],"date-time":"2018-01-03T00:00:00Z","timestamp":1514937600000},"content-version":"vor","delay-in-days":2,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Internal Medicine Journal"],"published-print":{"date-parts":[[2018,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Statin\u2010associated immmune\u2010mediated necrotising myopathy (IMNM) is an emerging entity. Being an uncommon condition, our knowledge and understanding is largely based on case series.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>To review incident cases of statin\u2010associated<jats:styled-content style=\"fixed-case\">IMNM<\/jats:styled-content>associated with anti\u20103\u2010hydroxy\u20103\u2010methyl\u2010glutaryl\u2010coenzyme A reductase (<jats:styled-content style=\"fixed-case\">HMGCR<\/jats:styled-content>) antibodies in a single New Zealand centre over a 2\u2010year period.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Four incident cases of statin\u2010associated<jats:styled-content style=\"fixed-case\">IMNM<\/jats:styled-content>were seen between 2014 and 2016. Their presentation, investigation, treatment and current response to treatment are summarised. Two of the four patients were Pacific Islanders despite a small Pacific Island population in the southern district health board. A literature search was performed focusing on the presentation, investigation and treatment of statin\u2010associated<jats:styled-content style=\"fixed-case\">IMNM<\/jats:styled-content>and also genetic associations with this entity to determine whether Pacific Islanders may be at increased risk<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>All four patients presented with profound weakness and recent exposure to atorvastatin. All proceeded to muscle biopsy. Two biopsies showed typical<jats:styled-content style=\"fixed-case\">IMNM<\/jats:styled-content>. One biopsy had mild changes, reported as possibly being compatible with anti\u2010<jats:styled-content style=\"fixed-case\">HMGCR<\/jats:styled-content>antibodies. The final biopsy had features consistent with<jats:styled-content style=\"fixed-case\">IMNM<\/jats:styled-content>, with some features suggestive of polymyositis. Two recent studies have shown an association between anti\u2010<jats:styled-content style=\"fixed-case\">HMGCR<\/jats:styled-content>antibodies and the<jats:italic><jats:styled-content style=\"fixed-case\">HLA\u2010DRB1<\/jats:styled-content>*11:01<\/jats:italic>haplotype. Interestingly,<jats:italic><jats:styled-content style=\"fixed-case\">HLA\u2010DRB1<\/jats:styled-content><\/jats:italic>alleles (including<jats:italic><jats:styled-content style=\"fixed-case\">HLA\u2010DRB1<\/jats:styled-content>*11:01<\/jats:italic>) were observed to be among the most frequent alleles in a Pacific Island population study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This is the first case series of statin\u2010associated<jats:styled-content style=\"fixed-case\">IMNM<\/jats:styled-content>with a focus on Pacific Islanders and raises the possibility that Pacific Islanders exposed to statins may be at increased risk of developing an immune\u2010mediated myopathy.<\/jats:p><\/jats:sec>","DOI":"10.1111\/imj.13575","type":"journal-article","created":{"date-parts":[[2017,8,7]],"date-time":"2017-08-07T08:26:34Z","timestamp":1502094394000},"page":"32-36","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Statin\u2010associated immune\u2010mediated necrotising myopathy: a New Zealand case series showing possible overrepresentation in Pacific Islanders"],"prefix":"10.1111","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7587-8238","authenticated-orcid":false,"given":"Michelle","family":"Woolley","sequence":"first","affiliation":[{"name":"Department of Rheumatology Dunedin Hospital Dunedin New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simon","family":"Stebbings","sequence":"additional","affiliation":[{"name":"Department of Medicine, Dunedin school of Medicine University of Otago Dunedin New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John","family":"Highton","sequence":"additional","affiliation":[{"name":"Department of Medicine, Dunedin school of Medicine University of Otago Dunedin New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2018,1,3]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.nmd.2006.10.007"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.21486"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.27572"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.30156"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/BOR.0b013e32834b324b"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11940-011-0119-8"},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.lpm.2011.01.005"},{"key":"e_1_2_5_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11910-011-0232-9"},{"key":"e_1_2_5_10_1","doi-asserted-by":"publisher","DOI":"10.1212\/NXI.0000000000000096"},{"key":"e_1_2_5_11_1","doi-asserted-by":"publisher","DOI":"10.1586\/1744666X.2016.1103181"},{"key":"e_1_2_5_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-003-1027-y"},{"key":"e_1_2_5_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.autrev.2013.07.001"},{"key":"e_1_2_5_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000000028"},{"key":"e_1_2_5_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11926-015-0548-6"},{"key":"e_1_2_5_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.bor.0000434673.85515.89"},{"key":"e_1_2_5_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11926-014-0433-8"},{"key":"e_1_2_5_18_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrrheum.2010.2"},{"key":"e_1_2_5_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejim.2012.01.004"},{"key":"e_1_2_5_20_1","doi-asserted-by":"publisher","DOI":"10.3109\/14397595.2013.874739"},{"key":"e_1_2_5_21_1","doi-asserted-by":"publisher","DOI":"10.1097\/BOR.0000000000000106"},{"key":"e_1_2_5_22_1","unstructured":"Statistics New Zealand. 2013 Census district health board tables. 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