Constitutional syndrome and chest pain as clinical onset feature of necrotizing myopathy with myocardial involvement

Vargas‐Hitos, José Antonio; Sáez-Urán, Luis Manuel; Rosales-Castillo, Antonio; Jiménez-Alonso, J

doi:10.1111/1756-185x.13158

Cited by 2 publications

(2 citation statements)

References 7 publications

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“…Three of the cases showed pericardial effusion like the present case [10,11,18], and two showed diastolic left ventricular dysfunction [18,20]. Three reports showed that the initial symptoms were related to heart failure [10,11,19]. Furthermore, Takeguchi-Kikuchi et al recently demonstrated that anti-SRP antibody-positive NM is associated with cardiomyopathy, which was demonstrated by myocardial biopsy, cardiac MRI, and fluorodeoxyglucose-positron emission tomography [18].…”

Section: Discussionmentioning

confidence: 49%

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Secondary cardiac involvement in anti-SRP-antibody-positive myopathy: an 87-year-old woman with heart failure symptoms as the first clinical presentation

et al. 2020

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Background: Necrotizing myopathy (NM) is defined by the dominant pathological feature of necrosis of muscle fibers without substantial lymphocytic inflammatory infiltration. Anti-signal recognition particle (SRP)-antibodypositive myopathy is related to NM. Anti-SRP-antibody-positive myopathy can comorbid with other disorders in some patients, however, comorbidity with malignant tumor and myopericarditis has still not been reported. Case presentation: An 87-year-old woman with dyspnea on exertion and leg edema was referred to our hospital because of suspected heart failure and elevated serum creatine kinase level. Upon hospitalization, she developed muscle weakness predominantly in the proximal muscles. Muscle biopsy and immunological blood test led to the diagnosis of anti-SRP-antibody-positive myopathy. A colon carcinoma was also found and surgically removed. The muscle weakness remained despite the tumor resection and treatment with methylprednisolone. Cardiac screening revealed arrhythmia and diastolic dysfunction with pericardial effusion, which recovered with intravenous immunoglobulin (IVIg) treatment. Conclusions:We reported the first case of anti-SRP-positive myopathy comorbid with colon carcinoma and myopericarditis. This case is rare in the point that heart failure symptoms were the first clinical presentation. The underlying mechanism is still not clear, however, physicians should be carefully aware of the neoplasm and cardiac involvement in anti-SRP-antibody positive-myopathy patients and should consider farther evaluation and management.

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Section: Discussionmentioning

confidence: 49%

“…We identified six case series reporting on patients with myopericarditis with anti-SRP-antibodies [9][10][11][18][19][20]. Three of the cases showed pericardial effusion like the present case [10,11,18], and two showed diastolic left ventricular dysfunction [18,20].…”

Section: Discussionmentioning

confidence: 91%

Secondary cardiac involvement in anti-SRP-antibody-positive myopathy: an 87-year-old woman with heart failure symptoms as the first clinical presentation

et al. 2020

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Anti-SRP Antibodies and Myocarditis in Systemic Sclerosis Overlap Syndrome with Immune-Mediated Necrotizing Myositis (IMNM)

Alexandru,

Donisa,

Bobirca

et al. 2024

Medicina

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Overlap syndrome of systemic sclerosis and idiopathic inflammatory myopathies is an increasingly frequent entity, but the association with immune-mediated necrotizing myositis has rarely been described. While myositis or myopathy may be features of scleroderma, it is imperative to correctly diagnose an overlap syndrome of these two, since it can be considered a different entity with specific management and a worse prognosis. Anti-signal recognition particle (anti-SRP) antibodies target the striated muscle fiber and inhibit myoblast regeneration, resulting in myofiber atrophy and necrosis. Anti-SRP antibodies are specific in immune-mediated necrotizing myopathy characterized by myonecrosis and minimal inflammatory reaction, with proximal muscle weakness and typical extra-muscular manifestation. There are controversial data on the association of cardiac manifestations and the presence of these antibodies, and recent studies cannot prove a significant correlation between the two. Myocarditis is a complication with an unpredictable, potentially severe outcome from heart failure and dilated cardiomyopathy to fatality. It can be difficult to diagnose, and a myocardial biopsy can be problematic in daily practice; thus, most practitioners rely on cardiac magnetic resonance with suggestive images for the correct diagnosis. This paper seeks to address the challenges associated with the diagnosis and treatment of collagen diseases by evaluating the role of anti-SRP antibodies in the pathogenesis of cardiac involvement.

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Constitutional syndrome and chest pain as clinical onset feature of necrotizing myopathy with myocardial involvement

Cited by 2 publications

References 7 publications

Secondary cardiac involvement in anti-SRP-antibody-positive myopathy: an 87-year-old woman with heart failure symptoms as the first clinical presentation

Secondary cardiac involvement in anti-SRP-antibody-positive myopathy: an 87-year-old woman with heart failure symptoms as the first clinical presentation

Anti-SRP Antibodies and Myocarditis in Systemic Sclerosis Overlap Syndrome with Immune-Mediated Necrotizing Myositis (IMNM)

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