Mitophagy in three cases of immune-mediated necrotizing myopathy associated with anti-3-hydroxy-3-methylglutaryl-coenzyme a reductase autoantibodies. ultrastructural and immunohistochemical studies

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• Report of three cases of necrotizing myopathy associated with anti-HMGCR autoantibodies.• Ultrastructural features of mitophagy and up-regulation of BNIP3 were observed.• They strongly suggest an important role of necrosis-like programmed cell death.• It is yet to be seen if these changes occur in other cases of this condition.• These cases may help in elucidating the pathomechanism and in developing treatment.

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