A Rare Cause of Transaminitis: Anti-3-Hydroxy-3-Methylglutaryl-CoA Reductase Myopathy

Authors

• Ross M. Dies, LSU Health Sciences Center - New OrleansFollow
• Peng-Sheng Ting, Tulane University School of Medicine, New Orleans, LA
• Munraj Singh, LSU Health Sciences Center - New OrleansFollow

Document Type

Article

Publication Date

6-22-2026

Publication Title

Cureus

Abstract

Persistent transaminitis has a very broad differential diagnosis, and extrahepatic causes may often be initially overlooked. Anti-3-hydroxy-3-methylglutaryl-CoA reductase (anti-HMGCR) myopathy is a subtype of immune-mediated necrotizing myopathy (IMNM) characterized by the presence of anti-HMGCR antibodies and myofiber injury. Patients typically present with proximal extremity weakness, transaminitis, and a history of statin use. Unlike statin intolerance or statin myopathy, the weakness and biochemical abnormalities persist despite discontinuation of the drug. Here, we present a case of a patient with transaminitis and elevated creatine kinase (CK) levels, which persisted after cessation of his statin and were found to be associated with mildly elevated anti-HMGCR antibodies. Interestingly, he did not require immunosuppression for the resolution of his myopathy.

First Page

1

Last Page

5

PubMed ID

42488255

Volume

18

Issue

6

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Recommended Citation

Dies, Ross M.; Ting, Peng-Sheng; and Singh, Munraj, "A Rare Cause of Transaminitis: Anti-3-Hydroxy-3-Methylglutaryl-CoA Reductase Myopathy" (2026). School of Medicine Faculty Publications. 4922.
https://digitalscholar.lsuhsc.edu/som_facpubs/4922
10.7759/cureus.111300