How would you approach management of asymptomatic hyperCKemia with + HMG-CoA reductase antibodies and biopsy findings suggestive of immune-mediated myopathy?
CK ~1,600 to 3,000s, without objective muscle weakness. There is no history of statin use, OTC supplements, or substance abuse. Muscle biopsy shows a few necrotizing fibers. Would you recommend immunosuppressive treatment despite the absence of weakness?
1 Answer
Mednet MemberInvited Expert
Rheumatology · The University of Texas Health Science Center at Houston (UTHealth)
Answered on
As anti-HMGCR antibody testing becomes more common, we are likely to see more false-positive results. Still, most patients with positive anti-HMGCR antibodies eventually require treatment. In the 2017 Johns Hopkins cohort (PMID: 28096458), only 4 of 104 anti-HMGCR-positive patients did not require t...
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