Statin-induced autoimmune necrotizing myopathy with pharyngeal muscles involvement

Age Ageing. 2020 Aug 24;49(5):883-884. doi: 10.1093/ageing/afaa038.


Statins are widely prescribed in the treatment of hypercholesterolemia. While their efficacy in the secondary prevention of vascular events is proven, their safety profile in older patients with multiple co-morbidities and polypharmacy remains questionable. Although rare, antihydroxy-3-methylglutaryl-coenzyme A reductase (anti-HMGCR) myopathy is a severe adverse effect of statins, manifesting as myalgias, proximal muscle weakness, muscle cell necrosis and rhabdomyolysis. We report an uncommon case of an autopsy-proven anti-HMGCR necrotising myopathy predominately affecting pharyngeal muscles in an older patient, leading to dysphagia, pneumonia and death within 3 weeks from onset. Clinicians should screen for dysphagia in any patient with suspected anti-HMGCR myopathy, order an anti-HMGCR antibody titre and consider prompt immunosupressive therapy.

Keywords: anti-HMGCR necrotising myopathy; dysphagia; older patients; pharyngeal muscles necrosis; statins.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Autoantibodies
  • Autoimmune Diseases* / chemically induced
  • Autoimmune Diseases* / diagnosis
  • Autoimmune Diseases* / drug therapy
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors* / adverse effects
  • Muscular Diseases* / chemically induced
  • Muscular Diseases* / diagnosis
  • Myositis*
  • Pharyngeal Muscles


  • Autoantibodies
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors