Immune-Mediated Necrotizing Myopathy: Update on Diagnosis and Management

2015 ◽  
Vol 17 (12) ◽  
Author(s):  
Pari Basharat ◽  
Lisa Christopher-Stine
Keyword(s):  
Diagnosis And Management ◽  
Necrotizing Myopathy ◽  
Immune Mediated

Immune-Mediated Necrotizing Myopathy (IMNM)

2019 ◽  
pp. 225-235
Author(s):  
Brittany Adler ◽  
Lisa Christopher-Stine
Keyword(s):  
Necrotizing Myopathy ◽  
Immune Mediated

Clinical and genetic associations of autoantibodies to 3-hydroxy-3-methyl-glutaryl-coenzyme a reductase in patients with immune-mediated myositis and necrotizing myopathy

2015 ◽  
Vol 52 (2) ◽  
pp. 196-203 ◽  
Author(s):  
Vidya Limaye ◽  
Chris Bundell ◽  
Peter Hollingsworth ◽  
Arada Rojana-Udomsart ◽  
Frank Mastaglia ◽  
...  
Keyword(s):  
Coenzyme A ◽  
Genetic Associations ◽  
Necrotizing Myopathy ◽  
Immune Mediated ◽  
Coenzyme A Reductase

scholarly journals Immune-Mediated Necrotizing Myopathy: An Often Misdiagnosed Entity

2015 ◽  
Vol 2 (1) ◽  
Author(s):  
Joana Espírito Santo ◽  
Rui Garcia ◽  
Benilde Barbosa ◽  
Olinda Rebelo ◽  
José Pereira de Moura
Keyword(s):  
Necrotizing Myopathy ◽  
Immune Mediated

Statin-triggered immune-mediated necrotizing myopathy

2016 ◽  
Vol 64 (3) ◽  
pp. 562 ◽  
Author(s):  
Samir Patel ◽  
Anshu Rohatgi ◽  
Pooja Gupta
Keyword(s):  
Necrotizing Myopathy ◽  
Immune Mediated

scholarly journals Immune checkpoint inhibitor-associated myopathy: a clinicoseropathologically distinct myopathy

2020 ◽  
Vol 2 (2) ◽  
Author(s):  
Shahar Shelly ◽  
James D Triplett ◽  
Marcus V Pinto ◽  
Margherita Milone ◽  
Felix E Diehn ◽  
...  
Keyword(s):  
Creatine Kinase ◽  
Immune Checkpoint ◽  
Immune Checkpoint Inhibitor ◽  
Checkpoint Inhibitor ◽  
Signal Recognition Particle ◽  
Ocular Involvement ◽  
Signal Recognition ◽  
Necrotizing Myopathy ◽  
Immune Mediated ◽  
Coa Reductase

Abstract Immune checkpoint inhibitors have revolutionized the landscape of cancer treatment. Alongside their many advantages, they elicit immune-related adverse events, including myopathy, which potentially result in substantial morbidity if not recognized and treated promptly. Current knowledge of immune checkpoint inhibitor-associated myopathy is limited. We conducted a 5-year retrospective study of patients with immune checkpoint inhibitor-associated myopathy. Clinical features, survival and ancillary test findings were analysed and compared with those of immune-mediated necrotizing myopathy patients without immune checkpoint inhibitor exposure seen during the same time period. We identified 24 patients with immune checkpoint inhibitor-associated myopathy (median age 69 years; range 28–86) and 38 patients with immune-mediated necrotizing myopathy. Ocular involvement occurred in 9/24 patients with immune checkpoint inhibitor exposure, without electrodiagnostic evidence of neuromuscular transmission defect, and in none of the immune-mediated necrotizing myopathy patients (P < 0.001). Myocarditis occurred in eight immune checkpoint inhibitor-associated myopathy patients and in none of the immune-mediated necrotizing myopathy patients (P < 0.001). Median creatine kinase was 686 IU/l in the immune checkpoint inhibitor cohort (seven with normal creatine kinase) compared to 6456 IU/l in immune-mediated necrotizing myopathy cohort (P < 0.001). Lymphopenia was observed in 18 and 7 patients with and without immune checkpoint inhibitor exposure, respectively (P < 0.001). Myopathological findings were similar between patients with and without immune checkpoint inhibitor exposure, consisting of necrotic fibres with no or subtle inflammation. Necrotic fibres however arranged in clusters in 10/11 immune checkpoint inhibitor-associated myopathy patients but in none of the immune checkpoint inhibitor-naïve patients (P < 0.001). Despite the lower creatine kinase levels in immune checkpoint inhibitor-exposed patients, the number of necrotic fibres was similar in both groups. Immune checkpoint inhibitor-associated myopathy patients had a higher frequency of mitochondrial abnormalities and less number of regenerating fibres than immune-mediated necrotizing myopathy patients (P < 0.001). Anti-hydroxy-3-methylglutaryl-CoA reductase or signal recognition particle antibodies were absent in patients with immune checkpoint inhibitor exposure but positive in two-thirds of immune checkpoint inhibitor-naïve patients. Most patients with immune checkpoint inhibitor-associated myopathy responded favourably to immunomodulatory treatments, but four died from myopathy-related complications and one from myocarditis. Intubated patients had significantly shorter survival compared to non-intubated patients (median survival of 22 days; P = 0.004). In summary, immune checkpoint inhibitor-associated myopathy is a distinct, treatable immune-mediated myopathy with common ocular involvement, frequent lymphopenia and necrotizing histopathology, which contrary to immune-mediated necrotizing myopathy, is featured by clusters of necrotic fibres and not accompanied by anti-hydroxy-3-methylglutaryl-CoA reductase or signal recognition particle antibodies. Normal or mildly elevated creatine kinase level does not exclude the diagnosis.

Autophagy markers LC3 and p62 accumulate in immune‐mediated necrotizing myopathy

2019 ◽  
Vol 60 (3) ◽  
pp. 315-327 ◽  
Author(s):  
Francesco Girolamo ◽  
Anna Lia ◽  
Tiziana Annese ◽  
Margherita Giannini ◽  
Angela Amati ◽  
...  
Keyword(s):  
Necrotizing Myopathy ◽  
Immune Mediated

scholarly journals Myositis-specific autoantibodies, a cornerstone in immune-mediated necrotizing myopathy

2019 ◽  
Vol 18 (3) ◽  
pp. 223-230 ◽  
Author(s):  
Céline Anquetil ◽  
Olivier Boyer ◽  
Nadège Wesner ◽  
Olivier Benveniste ◽  
Yves Allenbach
Keyword(s):  
Necrotizing Myopathy ◽  
Immune Mediated

scholarly journals Diagnosis and Management of Immune-Mediated Myopathies

2017 ◽  
Vol 92 (5) ◽  
pp. 826-837 ◽  
Author(s):  
Margherita Milone
Keyword(s):  
Diagnosis And Management ◽  
Immune Mediated

Enzyme-linked immunosorbent assays for diagnosis of immune-mediated necrotizing myopathy

2016 ◽  
Vol 7 (3) ◽  
pp. 291-293 ◽  
Author(s):  
Keisuke Ikemoto ◽  
Shigeaki Suzuki ◽  
Akinori Uruha ◽  
Yurika Watanabe ◽  
Jin Nakahara ◽  
...  
Keyword(s):  
Necrotizing Myopathy ◽  
Immune Mediated ◽  
Immunosorbent Assays
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