{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,2]],"date-time":"2025-08-02T19:08:35Z","timestamp":1754161715071,"version":"3.41.2"},"reference-count":0,"publisher":"AVES YAYINCILIK A.\u015e.","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["EJR"],"abstract":"<jats:p>Statin-associated immune-mediated necrotizing myopathy (IMNM) is a rare presentation of a statin-associated myopathy. Patients usually present with muscle weakness and pain in the setting of statin use with elevated creatine kinase (CK) levels and a positive anti-3-hydroxy-3-methylglutaryl-coenzyme A reductase (anti-HMGCR) antibody. Muscle biopsies typically show necrosis, CD68+ macrophages, and minimal lymphocytes. We present a case of a 67-year-old woman who had 2 months of progressive weakness and bilateral lower extremity pain after initiating atorvastatin therapy with symptoms persisting after statin cessation. She was found to have high anti-HMGCR antibody titers, and the biopsy of the rectus femoris muscle showed a prominent endomysial inflammatory cell infiltrate with necrotic and regenerative fibers and an atypical extensive inflammatory infiltrate composed of both CD4+ helper T cells and CD8+ cytotoxic T cells. She showed symptom resolution and normalization of CK levels and inflammatory markers with treatment involving a prolonged prednisone taper and a brief course of azathioprine, which was stopped because of the adverse effects.\n\nCite this article as: Zaki MM, Virk ZM, Lopez D, Klubnick J, Ahrendsen JT, Varma H, et al. A case of statin-associated immune-mediated necrotizing myopathy with atypical biopsy features. Eur J Rheumatol 2021; 8(1): 36-9.\n<\/jats:p>","DOI":"10.5152\/eurjrheum.2020.20064","type":"journal-article","created":{"date-parts":[[2020,12,28]],"date-time":"2020-12-28T06:20:40Z","timestamp":1609136440000},"page":"36-39","source":"Crossref","is-referenced-by-count":2,"title":["A case of statin-associated immune-mediated necrotizing myopathy with atypical biopsy features"],"prefix":"10.5152","volume":"8","author":[{"given":"Mark M.","family":"Zaki","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zain M.","family":"Virk","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Diego","family":"Lopez","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jenna","family":"Klubnick","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jared T.","family":"Ahrendsen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hemant","family":"Varma","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vasileios","family":"Kyttaris","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ilana","family":"Abeles","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"3111","published-online":{"date-parts":[[2021,1,1]]},"container-title":["European Journal of Rheumatology"],"original-title":[],"link":[{"URL":"https:\/\/www.eurjrheumatol.org\/index.php\/pub\/article\/download\/454\/454","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2025,7,29]],"date-time":"2025-07-29T07:13:35Z","timestamp":1753773215000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.eurjrheumatol.org\/index.php\/pub\/article\/view\/454"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,1,1]]},"references-count":0,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2021,1,27]]}},"URL":"https:\/\/doi.org\/10.5152\/eurjrheum.2020.20064","relation":{},"ISSN":["2148-4279"],"issn-type":[{"type":"electronic","value":"2148-4279"}],"subject":[],"published":{"date-parts":[[2021,1,1]]}}}