Rheumatologists from Baltimore (USA) report in the British Medical Journal the case of a thirty year old patient with autoimmune necrotizing myopathy with anti-HMGCR, with no history of statin treatment and well balanced on immunoglobulin infusions:
three months after starting a supplementation with Asian mushrooms (shiitake, maitake, reishi), she presented a muscular weakness with elevation of creatine kinase (CK) to 1696 U/l ;
- after stopping the food supplements, and without additional treatment, the CK level gradually returned to normal;
- the mushrooms in question contain, like red yeast rice, a natural inhibitor of hydroxyl-methyl-glutaryl-Co-A reductase (HMGCR);
- statins are also inhibitors of HMGCR, known as a possible trigger for autoimmune necrotizing myopathy.
The authors recommend avoiding the incriminating mushrooms, which are very present in Asian cuisine and in various food supplements, in this pathology. They also recommend that a thorough dietary investigation be carried out in patients suffering from autoimmune necrotising myopathy, especially if it remains poorly controlled by treatment.
