Evidence map›Paper›PMID 40421031›Full record

ReviewFrontiers in immunology2025

Anti-HMGCR myopathy: a first case report from North Africa and literature insights.

Houssem Abida, Imen Zamali, Imène Rachdi, Zakaria Saied, Ahlem Ben Hmid, Samar Samoud, Yousr Galai, Fatma Daoud, Fatma Boussema, Samia Ben Sassi and 2 more

Abstract readCase ReportsReview
In one paragraph

Review in Frontiers in immunology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Houssem AbidaFaculty of Medicine de Tunis, University of Tunis El Manar, Tunis, Tunisia.
Imen ZamaliFaculty of Medicine de Tunis, University of Tunis El Manar, Tunis, Tunisia.
Imène RachdiFaculty of Medicine de Tunis, University of Tunis El Manar, Tunis, Tunisia.
Zakaria SaiedFaculty of Medicine de Tunis, University of Tunis El Manar, Tunis, Tunisia.
Ahlem Ben HmidFaculty of Medicine de Tunis, University of Tunis El Manar, Tunis, Tunisia.
Samar SamoudLaboratory of Clinical Immunology, Institut Pasteur de Tunis, Tunis, Tunisia.
Yousr GalaiLaboratory of Clinical Immunology, Institut Pasteur de Tunis, Tunis, Tunisia.
Fatma DaoudFaculty of Medicine de Tunis, University of Tunis El Manar, Tunis, Tunisia.
Fatma BoussemaFaculty of Medicine de Tunis, University of Tunis El Manar, Tunis, Tunisia.
Samia Ben SassiFaculty of Medicine de Tunis, University of Tunis El Manar, Tunis, Tunisia.
Zohra AydiFaculty of Medicine de Tunis, University of Tunis El Manar, Tunis, Tunisia.
Mélika Ben AhmedFaculty of Medicine de Tunis, University of Tunis El Manar, Tunis, Tunisia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Anti-3-hydroxy-3-methylglutaryl-coenzyme A reductase (anti-HMGCR) myopathy is a rare idiopathic inflammatory myopathy characterized by severe muscle damage and minimal extra-muscular involvement. This report presents the first documented case of severe, treatment-resistant HMGCR-myopathy in a Tunisian and North African patient. A 43-year-old man with no significant medical history experienced progressive muscle weakness over one year, leading to difficulty walking. Examination revealed pronounced proximal muscle weakness, particularly in the lower limbs, with significant quadriceps atrophy. Laboratory results indicated elevated Creatine Kinase (CK) levels at 10000 UI/l and Lactate dehydrogenase (LDH) at 400 UI/l. Electromyography confirmed myogenic damage, and muscle biopsy revealed extensive muscle necrosis and regeneration with moderate inflammatory infiltrates. Screening for anti-HMGCR antibodies was positive. Initial treatment with high-dose prednisone showed a good response but led to flares upon tapering. Subsequent treatment with methotrexate, azathioprine, and rituximab resulted in partial clinical and biological improvement. This case underscores the challenges in diagnosing and managing anti-HMGCR myopathy due to limited awareness and access to testing.

Indexed as

AutoantibodiesAutoimmune DiseasesHydroxymethylglutaryl CoA ReductasesMuscular DiseasesMyositisAdultHumansMaleAutoantibodiesHMGCR protein, humanHydroxymethylglutaryl CoA Reductasesanti-HMGCRautoimmunitycase reportinflammatory myopathytherapeutics

Identifiers

PMID40421031
PMCPMC12104258

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.