Abstract
We report here a statin naive lady who had refractory myositis for years. The diagnosis was revised to be anti-HMGCR related immune mediated necrotizing myopathy after repeating the muscle biopsy and checking the autoantibody. This report serves as a diagnostic alert that anti-HMGCR related immune mediated necrotizing myopathy should be considered in refractory myositis cases even though there is no statin exposure history, as both the treatment and prognosis may differ.
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