HMGCR and hepatitis B virus infection: Her serology was unremarkable, with no antinuclear antibodies, myositis-associated or myositis-specific antibodies [including anti-3-Hydroxy-3-methylglutaryl-coenzyme A reductase (HMGCR) and anti-signal recognition particle (SRP) antibodies], or signs of viral hepatitis B or C. Muscle biopsy of the left vastus medialis showed extensive necrosis with only mild inflammatory changes (Fig. 2).