Suspicion of immune-mediated necrotizing myopathy (IMNM). Anti-HMCGR is strongly associated with previous statin therapy.
Method
Quanta Lite HMGCR ELISA
Response
The test result is given as negative or positive with a value. Reference value: Negative <20 U/mL, Positive ≥20 U/mL.
Interpretation
Antibodies against HMG-CoA reductase (HMGCR) are associated with necrotizing autoimmune-myopathy and can be detected in about 25% of these patients. Antibodies against HMGCR are associated with elevated levels of creatine kinase (CK) in blood. Pronounced proximal muscle weakness is typical while lung involvement is less common. Almost half of the cases have previous treatment with statins. The level of anti-HMGCR is well correlated to the muscle strength and level of creatine kinase (CK) in blood.
Anti-HMGCR is usually not detected in healthy subjects or in subjects with other inflammatory and autoimmune diseases.
References
Musset L et al., J Immunol Res. 2014; 2014:405956. PMID: 24741598
Allenbach et al, Medicine (Baltimore). 2014 May;93(3):150-7. PMID: 24797170
Drouot et al, Arthritis Res Ther. 2014 Feb 3;16(1): R39. PMID: 24484965
Hamann et al. Autoimmun Rev. 2013 Oct;12(12):1177-81. PMID: 23851103
Mohassel and Mammen, Curr Opin Rheumatol. 2013 Nov;25(6):747-52. PMID: 24061077
Mammen AL et al., Arthritis Rheum. 2011 Mar;63(3):713-21. PMID: 21360500
Soininen K et al, Basic Clin Pharmacol Toxicol 2006, 98: 51-4. PMID: 16433891
Needham M et al, Neuromusclul Disord 2007,17: 194-200. PMID: 17241784
Grable-Esposito p et al, Muscle Nerve 2010, 41: 185-90. PMID: 19813188
Mammen AL et al, Arth Care Res 2012, 64:269-72. PMID: 21972203
Payam Mohassel and Andrew L. Mammen, Journal of Neuromuscular Diseases 2018, 5: 11-20. PMID: 29480216
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ENSKILD ANALYS 485
HMGCR-antikroppar
Indikation
Misstanke om immunmedierad nekrotiserande myopati (IMNM). Anti-HMCGR är starkt kopplat till föregående statinbehandling.
Metod
Quanta Lite HMGCR ELISA
Svar
Svaret anges som negativt eller positivt med värde. Referensintervall: Negativ <20 U/mL, Positiv ≥20 U/mL.
Tolkning
Antikroppar mot HMG-CoA-Reduktas (HMGCR) är associerade med nekrotiserande autoimmun myopati och kan påvisas hos ca 25% av dessa patienter. Ofta ses kraftigt förhöjd nivå av kreatin kinas (CK) i blod. Uttalad proximal muskelsvaghet är typiskt medan lungengagemang är mindre vanligt. Nästan hälften av fallen har föregående behandling med statiner. Nivån av anti-HMGCR korrelerar väl till muskelstyrka och nivå av kreatin-kinas (CK) i blod.
Anti-HMGCR påvisas normalt inte hos friska eller hos personer med andra inflammatoriska och autoimmuna sjukdomar.
Referenser
Musset L et al., J Immunol Res. 2014; 2014:405956. PMID: 24741598
Allenbach et al, Medicine (Baltimore). 2014 May;93(3):150-7. PMID: 24797170
Drouot et al, Arthritis Res Ther. 2014 Feb 3;16(1): R39. PMID: 24484965
Hamann et al. Autoimmun Rev. 2013 Oct;12(12):1177-81. PMID: 23851103
Mohassel and Mammen, Curr Opin Rheumatol. 2013 Nov;25(6):747-52. PMID: 24061077
Mammen AL et al., Arthritis Rheum. 2011 Mar;63(3):713-21. PMID: 21360500
Soininen K et al, Basic Clin Pharmacol Toxicol 2006, 98: 51-4. PMID: 16433891
Needham M et al, Neuromusclul Disord 2007,17: 194-200. PMID: 17241784
Grable-Esposito p et al, Muscle Nerve 2010, 41: 185-90. PMID: 19813188
Mammen AL et al, Arth Care Res 2012, 64:269-72. PMID: 21972203
Payam Mohassel and Andrew L. Mammen, Journal of Neuromuscular Diseases 2018, 5: 11-20. PMID: 29480216