&lt;p&gt;Immune-Mediated Necrotizing Myopathy Initially Presenting as Erythema Nodosum&lt;/p&gt;

Ying, Shilong; Li, Sheng; Tang, Sha; Sun, Qingguo; Fang, Deren; Li, Yali; Zhu, Dexi; Fang, Hong; Qiao, Jianjun

doi:10.2147/jir.s270114

Cited by 3 publications

(3 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The combination of glucocorticoids and azathioprine has even been shown to successfully induce remission in seronegative IMNM patients [ 6 ]. Additional glucocorticoid-sparing agents such as rituximab and mycophenolate have also been shown to reduce disease burden [ 19 , 27 ].…”

Section: Discussionmentioning

confidence: 99%

Immune-Mediated Necrotizing Myopathy Manifesting after Five Years of Statin Therapy

DeRon

Fischer

Lopez

et al. 2023

Case Reports in Rheumatology

View full text Add to dashboard Cite

Immune-mediated necrotizing myopathy (IMNM) is an increasingly common and serious condition in which autoantibodies attack muscle fibers causing clinically significant muscle weakness, fatigue, and myalgias. Recognizing the clinical presentation of IMNM is difficult but necessary, as rapid intervention decreases morbidity. We present a case of a 53-year-old female with IMNM induced by statin therapy with confirmed anti-3-hydroxy-3-methylglutaryl coenzyme A reductase antibodies present on serologic testing. The patient’s statin therapy was halted, and the patient was provided with one dose of methylprednisolone and ongoing therapy with mycophenolate. She showed subsequent slow improvements in her muscle weakness and myalgias. It is important for clinicians to be aware of the possible consequences of statin therapy, as these drugs are generally regarded as benign in the medical community. Clinicians should also be aware that statin-induced myopathy can occur at any time during statin therapy. The condition does not necessarily correlate with beginning a new statin medication, as demonstrated in this case in which the patient was on chronic statin therapy before developing symptoms. Continued clinician education and building the fund of medical knowledge regarding this disease are vital to enable clinicians to recognize this disease and act promptly to reduce patient morbidity and improve outcomes.

show abstract

Section: Discussionmentioning

confidence: 99%

Immune-Mediated Necrotizing Myopathy Manifesting after Five Years of Statin Therapy

DeRon

Fischer

Lopez

et al. 2023

Case Reports in Rheumatology

View full text Add to dashboard Cite

show abstract

“…In our study, we reviewed all B-cell therapies for IMNM, and only RTX was identified to be effective (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(18)(19)(20)(21). B-cell depletion therapy with RTX in anti-SRP IMNM is commonly effective.…”

Section: Discussionmentioning

confidence: 99%

“…In previous reports, anti-B-cell therapy, especially rituximab (RTX), an anti-monoclonal CD20 antibody, has been used in IMNM (2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12). In some cases, patients benefited from RTX, while in other cases, patients showed poor response or died from complications, such as infection (2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12).…”

Section: Introductionmentioning

confidence: 99%

Belimumab for Immune-Mediated Necrotizing Myopathy Associated With Anti-SRP Antibodies: A Case Report and Retrospective Review of Patients Treated With Anti-B-Cell Therapy in a Single Center and Literature

Cui

Tian

et al. 2021

Front. Immunol.

View full text Add to dashboard Cite

BackgroundImmune-mediated necrotizing myopathy (IMNM) is characterized by markedly elevated creatinine kinase and histologically scattered necrotic muscle fibers and generally associated with autoantibodies against signal recognition particle (SRP) or 3-hydroxy-3-methylglutaryl-coA-reductase (HMGCR). Poor clinical response to conventional therapies and relapses commonly occur in severe cases. Anti-B-cell therapies have been used in refractory/relapsing cases.MethodsThe characteristics of a patient with IMNM associated with anti-SRP antibodies including physical examination, laboratory tests, and disease activity assessment were evaluated. Conventional therapy, belimumab treatment schedule, and follow-up data were recorded. Medical records of IMNM patients treated in our department from September 2014 to June 2021 were reviewed to evaluate the efficacy and safety of anti-B-cell therapy for anti-SRP IMNM. A literature review of patients with anti-SRP IMNM treated with anti-B-cell therapies was performed.ResultsWe describe a case of a 47-year-old woman with IMNM associated with anti-SRP antibodies who relapsed twice after conventional therapy but showed good response and tolerance to belimumab at 28 weeks follow-up. In this review, three patients from our department were treated with rituximab. Two of the three patients rapidly improved after treatment. Twenty patients and five retrospective studies were included in the literature review. All patients were administered rituximab as an anti-B-cell drug.ConclusionDespite a lack of rigorous clinical trials, considerable experience demonstrated that anti-B-cell therapy might be effective for patients with IMNM associated with anti-SRP antibodies. Belimumab in association with steroids might be an encouraging option for refractory/relapsing cases.

show abstract

Panniculitis

Requena,

Cerroni

2024

Rook's Textbook of Dermatology

View full text Add to dashboard Cite

The panniculitides represent a group of heterogeneous inflammatory diseases that involve the subcutaneous fat. The specific diagnosis of these disorders requires histopathological study because different panniculitides usually show monotonous clinical appearance, namely subcutaneous erythematous nodules on the lower extremities. Histopathological study of panniculitis is also challenging because of an inadequate clinicopathological correlation and the evolutionary nature of the lesions. Often, biopsy specimens are taken from late‐stage lesions, which results in non‐specific histopathological findings. In addition, large‐scalpel incisional biopsies are required. However, with adequate biopsy samples a histopathological differential diagnosis between a mostly septal and a mostly lobular panniculitis is straightforward and with adequate clinicopathological correlation, a specific diagnosis may be rendered in most cases of panniculitis. Mostly septal panniculitides with vasculitis include superficial thrombophlebitis and cutaneous polyarteritis nodosa (cutaneous arteritis). Septal panniculitides with no vasculitis may appear as the consequence of dermal inflammatory processes extending to the subcutaneous fat, such as necrobiosis lipoidica, scleroderma, subcutaneous granuloma annulare, rheumatoid nodule and necrobiotic xanthogranuloma, whereas in other cases the inflammatory process involves primarily the connective tissue septa of the subcutis with no participation of the overlying dermis. The most frequent septal panniculitis is erythema nodosum. In contrast, the most common lobular panniculitis with vasculitis is erythema induratum of Bazin (nodular vasculitis). Mostly lobular panniculitides without vasculitis comprise a large list of disorders, including sclerosing panniculitis (lipodermatosclerosis), subcutaneous fat necrosis of the newborn, panniculitis associated with connective tissue diseases, pancreatic panniculitis, 1 ‐antitrypsin deficiency‐associated panniculitis, infective panniculitis and factitious panniculitis. In recent years, several cases of both septal and lobular panniculitis have been described as a consequence of the administration of new drugs, including immune checkpoint inhibitors and BRAF inhibitors used as treatment of metastatic melanoma, tyrosine kinase and Bruton tyrosine kinase inhibitors used for treatment of leukemia and other haematological malignancies and tumour necrosis factor inhibitor drugs.

show abstract

<p>Immune-Mediated Necrotizing Myopathy Initially Presenting as Erythema Nodosum</p>

Cited by 3 publications

References 26 publications

Immune-Mediated Necrotizing Myopathy Manifesting after Five Years of Statin Therapy

Immune-Mediated Necrotizing Myopathy Manifesting after Five Years of Statin Therapy

Belimumab for Immune-Mediated Necrotizing Myopathy Associated With Anti-SRP Antibodies: A Case Report and Retrospective Review of Patients Treated With Anti-B-Cell Therapy in a Single Center and Literature

Panniculitis

Contact Info

Product

Resources

About