Mushroom supplements triggering a flare of HMGCR immune mediated necrotising myopathy.
Mushroom supplements triggering a flare of HMGCR immune mediated necrotising myopathy.
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DOI：
10.1136/bcr-2022-248880
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发表时间：
2022-05-23
期刊：
影响因子：
0.9
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中科院分区：
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羟甲基戊二酰辅酶 A 还原酶 (HMGCR) 免疫介导的坏死性肌病 (IMNM) 是一种罕见的自身免疫性肌炎，被认为是由他汀类药物引发并对免疫调节产生反应。我们报告了一例患有 HMGCR IMNM 的 30 多岁女性，没有他汀类药物暴露史，她在开始服用蘑菇补充剂后出现明显的肌炎症状。蘑菇是天然的 HMGCR 抑制剂，这是第一个在已知 HMGCR IMNM 患者中证明蘑菇引发症状的病例。该病例强调了审查 IMNM 患者饮食和补充剂的重要性。它还强调了即使肌炎得到良好控制，IMNM 患者严格避免使用他汀类药物的重要性。
Hydroxyl-methyl-glutaryl-Co-A reductase (HMGCR) immune mediated necrotising myopathy (IMNM) is a rare autoimmune myositis that is thought to be triggered by statins and responds to immunomodulation. We report a case of a woman in her 30s with HMGCR IMNM without a history of statin exposure who had a clear flare of her myositis after beginning mushroom supplements. Mushrooms are natural HMGCR inhibitors, and this is the first case to demonstrate a flare triggered by mushrooms in a patient with known HMGCR IMNM. This case highlights the importance of reviewing diet and supplements in patients with IMNM. It also emphasises the importance of strict statin avoidance for patients with IMNM even when the myositis is under good control.