scholarly journals IMMUNE-MEDIATED NECROTIZING MYOPATHY: AN IMPORTANT DIFFERENTIAL DIAGNOSIS OF MUSCLE WEAKNESS

2021 ◽  
Vol 1 (8) ◽  
pp. 2-2
Author(s):  
Camila Aguiar Lomônaco ◽  
Dayani Regina de Barros Freitas ◽  
Nelson Araujo Silva Filho ◽  
Carla Oliveira Monteiro da Silva ◽  
Carolina Arribada Rebello
Keyword(s):  
Differential Diagnosis ◽  
Muscle Weakness ◽  
Necrotizing Myopathy ◽  
Important Differential Diagnosis ◽  
Immune Mediated

scholarly journals Immune-mediated necrotizing myopathy: an important differential diagnosis of muscle weakness

2021 ◽  
Author(s):  
Camila Aguiar Lomônaco ◽  
Dayani Regina de Barros Freitas dos Santos ◽  
Nelson Araújo Silva Filho ◽  
Carla Oliveira Monteiro da Silva ◽  
Carolina Arribada Rebello
Keyword(s):  
Differential Diagnosis ◽  
Muscle Weakness ◽  
Necrotizing Myopathy ◽  
Important Differential Diagnosis ◽  
Immune Mediated

scholarly journals Isolated Oropharyngeal Dysphagia as the Initial Presentation of Anti-SRP Immune-Mediated Necrotizing Myopathy

2020 ◽  
Author(s):  
Pat Korathanakhun ◽  
Thanyalak Amornpojnimman
Keyword(s):  
Muscle Weakness ◽  
Clinical Course ◽  
Signal Recognition Particle ◽  
Oropharyngeal Dysphagia ◽  
Signal Recognition ◽  
Proximal Muscle Weakness ◽  
Proximal Muscle ◽  
Necrotizing Myopathy ◽  
Immune Mediated ◽  
Electrodiagnostic Study

A 51-year-old male initially presented with a progressive course of isolated oropharyngeal dysphagia prior to the clinical course of painful symmetrical proximal muscle weakness without sensory deficit which rendered him to wheelchairbound status within 5 months. The physical examination revealed symmetrical proximal muscle weakness without sensory symptoms. The initial serum creatine kinase was extremely high and the electrodiagnostic study revealed a myopathic pattern. A muscle biopsy of the left biceps suggested a diagnosis of immune-mediated necrotizing myopathy (IMNM) and the serum anti-signal recognition particle (SRP) autoantibody was finally detected. This case presented a rare form of anti-SRP IMNM in which isolated oropharyngeal dysphagia preceded the onset of proximal muscle weakness.

Intracerebral haemorrhage and Guillain-Barré syndrome: an exploration of potential pathophysiology

2021 ◽  
Vol 14 (8) ◽  
pp. e243245
Author(s):  
Sophia Connor ◽  
Omar Azzam ◽  
David Prentice
Keyword(s):  
Differential Diagnosis ◽  
Intracerebral Haemorrhage ◽  
Molecular Mimicry ◽  
Guillain Barre Syndrome ◽  
Important Differential Diagnosis ◽  
Immune Mediated ◽  
Guillain Barré Syndrome ◽  
Guillain Barré

Guillain-Barré syndrome (GBS) is an immune-mediated polyneuropathy classically thought to be caused by infections through the process of molecular mimicry. We report a case of GBS caused by intracerebral haemorrhage and postulate potential theories for the development of GBS following intracerebral haemorrhage and other non-infectious aetiologies by association. We highlight that GBS is an important differential diagnosis in patients developing generalised paresis following intracerebral haemorrhage.

scholarly journals Statin-associated anti-HMGCR immune-mediated necrotizing myopathy with dermatomyositis-like features: A case report

2020 ◽  
Vol 8 ◽  
pp. 2050313X2098412
Author(s):  
Darosa Lim ◽  
Océane Landon-Cardinal ◽  
Benjamin Ellezam ◽  
Annie Belisle ◽  
Annie Genois ◽  
...  
Keyword(s):  
Creatine Kinase ◽  
Muscle Weakness ◽  
Inflammatory Myopathy ◽  
Idiopathic Inflammatory Myopathy ◽  
Intravenous Immunoglobulins ◽  
Proximal Muscle Weakness ◽  
Proximal Muscle ◽  
Therapeutic Implications ◽  
Necrotizing Myopathy ◽  
Immune Mediated

Anti-3-hydroxy-3-methylglutaryl-coenzyme A reductase (HMGCR) immune-mediated necrotizing myopathy is a subtype of idiopathic inflammatory myopathy which may be associated with statin exposure. It presents with severe proximal muscle weakness, high creatine kinase levels and muscle fiber necrosis. Treatment with intravenous immunoglobulins and immunosuppressants is often necessary. This entity is not commonly known among dermatologists as there are usually no extramuscular manifestations. We report a rare case of statin-associated anti-HMGCR immune-mediated necrotizing myopathy with dermatomyositis-like cutaneous features. The possibility of anti-HMGCR immune-mediated necrotizing myopathy should be considered in patients with cutaneous dermatomyositis-like features associated with severe proximal muscle weakness, highly elevated creatine kinase levels and possible statin exposure. This indicates the importance of muscle biopsy and specific autoantibody testing for accurate diagnosis, as well as significant therapeutic implications.

scholarly journals Prominent Asymmetric Muscle Weakness and Atrophy in Seronegative Immune-Mediated Necrotizing Myopathy

Diagnostics ◽  
2021 ◽  
Vol 11 (11) ◽  
pp. 2064
Author(s):  
Sunha Park ◽  
Dae-Hyun Jang ◽  
Jae-Min Kim ◽  
Nara Yoon
Keyword(s):  
Lower Extremity ◽  
Muscle Weakness ◽  
Inflammatory Myopathy ◽  
Previous History ◽  
Lower Extremity Weakness ◽  
Necrotizing Myopathy ◽  
Left Lower Extremity ◽  
Thigh Muscles ◽  
Immune Mediated ◽  
The Right

Immune-mediated necrotizing myopathy, a new subgroup of inflammatory myopathies, usually begins with subacute onset of symmetrical proximal muscle weakness. A 35-year-old male presented with severe asymmetric iliopsoas atrophy and low back pain with a previous history of left lower extremity weakness. Although his first left lower extremity weakness occurred 12 years ago, he did not receive a clear diagnosis. Magnetic resonance imaging of both thigh muscles showed muscle edema and contrast enhancement in patch patterns, and the left buttock and thigh muscles were more atrophied compared to the right side. Serum creatine kinase levels were elevated, and serologic testings were all negative. Genetic testing using a targeted gene-sequencing panel for neuromuscular disease including myopathy identified no pathogenic variants. Muscle biopsy on the right vastus lateralis showed scattered myofiber necrosis with phagocytosis and an absence of prominent inflammatory cells, consistent with seronegative necrotizing myopathy. Thus, unusual asymmetric muscle weakness and atrophy can be a manifestation of inflammatory myopathy.

A Case of Immune-Mediated Necrotizing Myopathy With Associated Skeletal Muscle Involvement by Sarcoid Granulomata: A Rare Association

2019 ◽  
Vol 152 (Supplement_1) ◽  
pp. S69-S69
Author(s):  
Shalla Akbar ◽  
Sandhya Dasaraju ◽  
Osama Elkadi
Keyword(s):  
Skeletal Muscle ◽  
Muscle Weakness ◽  
Inflammatory Myopathies ◽  
Proximal Muscle Weakness ◽  
Proximal Muscle ◽  
Muscle Enzymes ◽  
Muscle Involvement ◽  
Necrotizing Myopathy ◽  
Immune Mediated ◽  
Skeletal Muscle Involvement

Abstract Skeletal muscle involvement by noncaseating granulomata occurs in a variety of conditions, including sarcoidosis, infections, and rarely in association with primary inflammatory myopathies such as inclusion body myositis (IBM) and dermatomyositis (DM). Sarcoid myopathy is typically asymptomatic; however, a picture of acute myositis with proximal muscle weakness has been described. Immune-mediated necrotizing myopathy (IMNM) is a subgroup of inflammatory myopathies typically presenting with proximal muscle weakness and markedly elevated muscle enzymes, mostly occurring in the setting of statin treatment. IMNM is associated with positive autoantibodies, but a subset of cases is antibody negative. Here we describe a case of myopathy occurring in association with sarcoidosis with combined features of granulomatous and necrotizing myopathy. The patient was a 54-year-old African American male with medical history significant for statin use 3 years ago, which was discontinued due to myalgia and elevated muscle enzymes and biopsy-proven sarcoidosis diagnosed on a pulmonary lymph node biopsy. He presented with progressive worsening of bilateral proximal weakness involving the upper and lower extremities. Electromyogram showed features of active myopathy with no evidence of peripheral neuropathy. Myositis panel was negative for the following antibodies: anti-Jo1, Mi-2, anti-Ku, PL-7, PL-12, OJ, EJ, and SRP. However, there was elevation of aldolase, CRP, and CK-MB. Biopsy of thigh and deltoid muscle showed necrotic muscle fibers, myophagocytosis with associated minimal inflammation, and multiple well-formed nonnecrotizing granulomas with multinucleated giant cells. Myopathic features include increased internalized nuclei, round atrophic fibers, and scattered split fibers. Specific features of IBM or DM were not present. Conclusion Myopathies developing or worsening after discontinuation of statin are rare. The association of necrotizing myopathy with sarcoidosis is not well described in the literature. Additional studies are warranted to elucidate this association.

scholarly journals GBS with Bilateral plantar extensor – A case report

2015 ◽  
Vol 31 (1) ◽  
pp. 42-44
Author(s):  
Hafizur Rahman ◽  
MA Hannan ◽  
Md Arifuzzaman ◽  
Mahabub Ara Abbasi
Keyword(s):  
Differential Diagnosis ◽  
Case Report ◽  
Muscle Weakness ◽  
Bladder Function ◽  
Intravenous Methylprednisolone ◽  
Immune Mediated ◽  
Extensor Plantar Response

GBS is an immune mediated polyradiculoneuropathy classically characterized by acute symmetrical ascending lower motor type weakness and areflexia. But sometimes, in axonal variants of GBS, reflexes are preserved or exaggerated. We report a case of GBS with bilateral extensor plantar response during the course of the disease. A 36- year-old male presented with acute quadriplegia with asymmetrical muscle weakness and extensor plantar response. Sensory, bowel and bladder function was intact. He was treated with intravenous methylprednisolone daily for 5 days without improvement. NCS revealed AIDP and AMAN variants of GBS. So, in any patient presenting with acute quadriplegia with extensor plantar response, GBS should be considered as differential diagnosis. Bangladesh Journal of Neuroscience 2015; Vol. 31 (1): 42-44

Sign in / Sign up

Export Citation Format

Share Document