Seronegative necrotizing autoimmune myopathy with favorable response to intravenous immunoglobulin

Liu, Rebecca; Fenves, Andrew Z.; Champion, Samantha N; Dau, Jonathan

doi:10.1080/08998280.2021.1885091

Cited by 3 publications

(3 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The serum levels of muscle enzymes are significant (268 times the normal range for creatine kinase, 63 times for myoglobin, and 40 times for aldolase). This is in contrast with the seropositive subtypes (usually around 30-fold range) [4] and other case reports of the seronegative subtype (40 to 60-fold range for creatine kinase) [10][11][12]. Also, in this case, myalgia and rhabdomyolysis recovered significantly before any specific treatment began, even though motor recovery only started after corticosteroids and methotrexate.…”

Section: Discussioncontrasting

confidence: 87%

“…We consider this case to be different from other similar cases published of seronegative IMNM, due to the severity of clinical presentation. Our patient presented to the emergency department with severe motor impairment, a very marked elevation of serum levels of muscle enzymes, and severe acute kidney injury, in a subacute evolution (six weeks versus four to five months as in other case reports) [9][10][11][12]. The serum levels of muscle enzymes are significant (268 times the normal range for creatine kinase, 63 times for myoglobin, and 40 times for aldolase).…”

Section: Discussionsupporting

confidence: 54%

See 1 more Smart Citation

A Rare Case of Rhabdomyolysis

Pombo¹,

Raposo²,

Martins³

et al. 2022

Cureus

View full text Add to dashboard Cite

Rhabdomyolysis is a pathological condition presenting with symptoms of localized or generalized myalgia and weakness, associated with an increase in serum creatine kinase level and, often leading to myoglobinuria and acute kidney injury. It has a wide range of etiologies. Immune-mediated necrotizing myopathy (IMNM) is a rare type of inflammatory myopathy, that leads to rhabdomyolysis, and it is divided into three different subtypes: anti-3-hydroxy-3-methylglutaryl-coA reductase (anti-HMGCR, anti-signal recognition particle (anti-SRP), and seronegative. There are slight differences in incidence, age of onset, clinical course, and prognosis between these subtypes.We describe the case of a 67-year-old female with myalgias and weakness of the thighs for six weeks. Laboratory findings showed marked rhabdomyolysis and severe acute kidney injury. The workup led to the diagnosis of seronegative immune-mediated necrotizing myopathy (IMNM) and treatment with corticosteroid and methotrexate was introduced, which led to marked clinical improvement.

show abstract

Section: Discussioncontrasting

confidence: 87%

Section: Discussionsupporting

confidence: 54%

A Rare Case of Rhabdomyolysis

Pombo¹,

Raposo²,

Martins³

et al. 2022

Cureus

View full text Add to dashboard Cite

show abstract

“…The serological finding of anti-3-hydroxy-3-methylglutaryl-coenzyme A reductase antibodies, through immunofluorescence or enzyme immunoassay tests, a finding of CK level >3000 IU/L, or a muscle biopsy that highlights the presence of muscle necrosis (without vasculitis, inflammation, or cellular infiltrates), indicates the presence of SINAM [8][9][10]. SINAM results in complaints of symmetrical weakness in the limbs, particularly in the lower limbs, weakness of the cervical muscles, and possible dysphagia (Figure 1) [11].…”

Section: Discussionmentioning

confidence: 99%

Immune-Mediated Myopathy in a Patient Presenting for Melanoma Resection and Sentinel Lymph Node Biopsy

Escher¹,

Hoffman²,

Alfieri³

et al. 2022

Cureus

View full text Add to dashboard Cite

Statin-induced necrotizing autoimmune myopathy (SINAM) is a rare side effect in people who are taking a class of drugs called statins. Patients with SINAM will present with subacute severe symmetric proximal muscle weakness. In contrast to more common myopathies, SINAM may not spontaneously resolve with statin discontinuation. These patients may require long-term immunotherapy to limit further disease progression. In this case study, we report a 74-year-old female with SINAM who presented for radical excision of a right upper back melanoma and sentinel lymph node biopsy at an outpatient facility. An anesthetic plan was crafted with the use of a supraglottic airway device without neuromuscular blockade.

show abstract