Polymyositis evolving after rhabdomyolysis associated with HMG-CoA reductase inhibitors: A report of two cases

3-Hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase inhibitors are co mmonly used for treatment of hyperlipidemia and its deleterious effects. My otoxicity has been associated with use of these agents. We report two cases of inflammatory myopathy in patients receiving these agents that did not r espond to drug withdrawal and required immunosuppressive treatment. One of these patients developed an antibody to histidyl tRNA synthetase or Jo-1, a n autoantibody associated With idiopathic inflammatory myopathies. We sugge st that HMG-CoA reductase inhibitor-associated myotoxicity may trigger an i mmune-mediated inflammatory myopathy. Patients whose muscle abnormalities d o not resolve with drug withdrawal should be considered for muscle biopsy.