Rare Anti-HMGCR-Induced Immune-Mediated Necrotising Myopathy: A Case Report and Literature Review

An acute necrotising myopathy is a distinct form of uncommon muscle disease characterised by the rapid advancement of weakness affecting the limbs, neck, pharyngeal, respiratory, and occasionally cardiac muscles. It frequently arises as part of idiopathic inflammatory myopathies, which include conditions like polymyositis, dermatomyositis, and inclusion body myositis. Anti-hydroxy-3-methylglutaryl-coenzyme A reductase represents an infrequent immune-mediated necrotising myopathy. This case study involves a 55-year-old African American woman experiencing muscle weakness and recurrent falls over 2 months with elevated creatine kinase levels, indicating an inflammatory disease process. The patient received symptomatic management after excluding any critical illness. After initial treatment, she underwent outpatient follow-up along with necessary investigations that led to the definitive diagnosis.