Association of idiopathic inflammatory myopathy and Crohn’s disease

Szabó, Nóra Anna; Lukacs, Sz.; Kulcsar, I.; Gunasekera, Wiranthi; Nagy-Toldi, A.; Dezső, Balázs; Dankó, Katalin

doi:10.1007/s10067-008-1032-8

Cited by 13 publications

(3 citation statements)

References 11 publications

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“…In this case, IIM was diagnosed in a CD-stable period. In previous case reports, acute exacerbation of IBD was associated with myositis recurrence 3,4 and IBD treatment was associated with IMM improvement, even in corticosteroid-refractory disease. 2,7 Here, without any change in CD therapy, there was a significant improvement with corticosteroids.…”

Section: Discussionmentioning

confidence: 80%

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Dermatomyositis and Crohn's disease – Case report

et al. 2023

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Immune‐mediated diseases tend to overlap in ways that are not completely understood. When a presentation is not entirely explained by a former condition, other hypotheses should arise. Additionally, the activity of 2 overlapping immune‐mediated conditions is not always associated. We present an unusual association between Crohn's disease and dermatomyositis in a 28‐year‐old man. The patient presented with a 2‐month history of proximal muscle weakness and a skin rash with heliotrope periorbital edema. Since the patient had already been diagnosed with Crohn's disease, he was under immunosuppressive therapy, and he had a family history of psoriasis, the diagnosis was not immediate and required an integrative approach. Laboratory analysis revealed elevated creatine kinase, aldolase, lactic dehydrogenase and transaminase levels. He had no symptoms of Crohn's disease exacerbation. Magnetic resonance imaging, electromyography, and muscle biopsy findings were consistent with inflammatory myopathy, although non‐specific. Corticosteroids were initiated with clinical and laboratory improvement within 1 month.

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Section: Discussionmentioning

confidence: 80%

“…2 However, data are still scarce to make conclusions about the tendencies of the association; it is even controversial whether if myositis is associated or not with IBD activity. 3,4 This report adds another example of this rare association to the literature and discusses diagnosis challenges and management strategies.…”

Section: Introductionmentioning

confidence: 97%

Dermatomyositis and Crohn's disease – Case report

et al. 2023

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“…Moreover, peripheral neuropathy is not well characterized in IBD and its incidence varies from 0.9 to 3.6% [5,6]. Chronic idiopathic inflammatory myopathy (IIM) is also a rare association with CD, with one known study by Szabo et al of a female CD patient presenting with chronic IIM [7]. …”

Section: Introductionmentioning

confidence: 99%

The concurrent association of inflammatory polymyositis and Crohn’s ileo-colitis in a Sri Lankan man: a case report of a rare association and literature review

et al. 2014

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BackgroundCrohn’s disease is a relapsing, systemic inflammatory disease affecting the gastrointestinal tract with associated extraintestinal manifestations and immune disorders. Among the few cases reported, the association of Crohn’s disease with polymyositis varies in its complexity and severity. We report here the first known case of inflammatory polymyositis leading to rhabdomyolysis in a male patient diagnosed with Crohn’s ileocolitis.Case presentationA 42-year-old previously healthy man presented with acute polymyositis leading to rhabdomyolysis. The acute nature of the illness raised the suspicion of an infective, toxic, or metabolic insult, which was excluded during further investigations. Prolonged low-grade fever and raised inflammatory markers led to the suspicion of inflammatory polymyositis, which was confirmed by electromyography and muscle histology. In the absence of an infective cause, the concurrent association of prolonged diarrhea containing blood and mucous after recovery from an acute phase of myositis proved a diagnostic challenge. Ileocolonoscopy findings of extensive aphthous ulceration with skip lesions extending to the terminal ileum, and histology showing polymorph infiltration of the lamina propria, transmural involvement, and micro abscess formation was suggestive of Crohn’s disease. Sensory motor axonal peripheral neuropathy, which is another rare association of inflammatory bowel disease, was also present.ConclusionAn unrecognized genetic predisposition or altered gut permeability causing disruption of the gut immune barrier triggering an immune response against skeletal muscles may have contributed to this unique association. Both polymyositis and Crohn’s ileocolitis responded well to corticosteroids and azathioprine, which is supportive of their immune pathogenesis. Myositis can be considered to be a rare extraintestinal manifestation of Crohn’s disease and can be used in the differential diagnosis of corticosteroid or hypokalemia-induced myopathy in Crohn’s disease.

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