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. 2019 Dec 1;12(11):e232406. doi: 10.1136/bcr-2019-232406

Table 1.

Summarisation of cases

Cases Case 1 Case 2 Case 3
Age of onset (years) 60 68 62
Gender Female Female Male
Statin Atorvastatin and rosuvastatin Atorvastatin Atorvastatin
Duration from symptom onset to presentation 2 months 1 month 12 months
Duration from commencement of statin to symptom onset Atorvastatin: few months
Rosuvastatin: 2 months
Atorvastatin: 3 years Atorvastatin: 3 years
Pattern of weakness Proximal upper and lower limbs Proximal upper and lower limbs Proximal, especially hip girdle
Initial peak CK 11 003 3900 5000
Anti-HMGCR antibody at presentation 54.4 RU (normal range <11.0 RU) 49.0 RU (normal range <11.0 RU) 0.84 (normal <0.24 OD units)
Muscle biopsy Focal segmental necrotising myopathy with minimal inflammation Moderate necrotising myopathy with minimal inflammation Necrotising myopathy
Immunotherapies trialled Prednisolone
Methotrexate
Cyclosporine
IVIG
Prednisolone
Methotrexate
Cyclosporine
IVIG
Prednisolone
Methotrexate
Cyclosporine
IVIG
Plasma exchange
Current immunotherapy Methotrexate
Rituximab
Methotrexate
IVIG
Rituximab
Methotrexate
IVIG
Rituximab
Current status Stable CK (<100 U/L)
Normal anti-HMGCR antibody level
Mild weakness
Stable CK (200~300 U/L)
Reduced anti-HMGCR antibody level
Mild weakness
Stable CK (100~300 U/L)
Anti-HMGCR antibody level still elevated
Mild weakness

anti-HMGCR, antibodies to 3-hydroxy-3-methylglutaryl coenzyme A reductase; CK, creatine kinase; IVIG, intravenous immunoglobulin; OD, Optical Density; RU, Reference Unit.