Miopatia Imunomediada por Anticorpos Anti-HMGCR: Revisão da Literatura com Base num Caso Clínico
DOI:
https://doi.org/10.24950/rspmi/Revisao/5/19/4/2019Palavras-chave:
Autoanticorpos, Doenças Autoimunes, Doenças Musculares, Hidroximetilglutaril-CoA Redutases, Inibidores de Hidroximetilglutaril-CoA Redutases, MiositeResumo
As estatinas estão entre os medicamentos mais prescritos a nível mundial e são geralmente seguros. Recentemente
foi caracterizada uma forma rara, mas potencialmente grave,
de complicação das estatinas e que pode surgir anos após o
início da medicação – a miopatia necrotizante imunomediada
(MNIM) anti-3-hidroxi-3-metilglutaril-coenzima A redutase (antiHMGCR). A propósito de um caso clínico que ilustra a forma
clássica de apresentação da MINIM anti-HMGCR, faz-se uma
revisão da literatura. Mulher de 67 anos medicada com sinvastatina há 5 anos, apresenta-se com quadro subagudo caracterizado por mialgias e tetraparésia de predomínio proximal,
elevação da creatina quinase, padrão miopático no eletromiograma, biópsia muscular compatível com miopatia necrotizante
e anticorpos anti-HMGCR. Suspendemos a estatina e instituímos terapêutica imunossupressora, tendo a evolução sido
favorável. A distinção entre a MNIM anti-HMGCR e outras
miopatias é fundamental, para que o tratamento possa ser instituído atempadamente. Assim, é importante que os clínicos
estejam familiarizados com esta doença.
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