Abstract
Autosomal recessive limb-girdle muscular dystrophy (LGMD) 2L is caused by mutations in the anoctamin-5-gene ( ANO5 ) that encodes a calcium-activated chloride channel.1,2 Limb-girdle muscle weakness can also be caused by an immune-mediated necrotizing myopathy (IMNM) with antibodies against 3-hydroxy-3-methylglutaryl-coenzyme-A-reductase (HMGCR), which catalyzes a rate-limiting step in cholesterol biosynthesis and is inhibited by statins.3,4 We report on a patient with LGMD2L and HMGCR-associated IMNM without previous statin exposure. The authors thank the technical personnel of the Departments of Neuropathology, Neurology, and Radiology, RWTH University Aachen, Germany, for technical assistance; and Dr. A. Vigneron (D-Tek, Mons, Belgium, specialized in the development of diagnostic tests in autoimmune disorders) for performing the myositis-specific and myositis-associated antibody assays, including HMGCR.
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