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Case 61 - Immune-Mediated Necrotizing Myopathy (IMNM)

from Myopathies

Published online by Cambridge University Press:  29 November 2024

Jessica E. Hoogendijk ,
Marianne de Visser ,
Pieter A. van Doorn  and
Erik H. Niks
Jessica E. Hoogendijk
Affiliation:
University Medical Center Utrecht
Marianne de Visser
Affiliation:
Amsterdam University Medical Center
Pieter A. van Doorn
Affiliation:
Erasmus MC, University Medical Center, Rotterdam
Erik H. Niks
Affiliation:
Leiden University Medical Center
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Summary

At the age of 44 years, this now 57-year-old woman noticed myalgia and difficulty walking, progressing over weeks. Two weeks after the first complaints, lifting the arms became troublesome too. CK activity was found to be > 10,000 U/L. TSH was normal. A diagnosis of myositis was made, and prednisone was started at a dose of 60 mg daily (body weight 80 kg). CK decreased, but the complaints worsened. Six weeks after disease onset, she was presented at our hospital. She was otherwise healthy, apart from well-controlled Graves disease with orbitopathy at the age of 31 years.

Keywords

myositisimmune-mediated necrotising myopathyIMNMHMGCR antobodiesSRP antibodiesmuscle fibre necrosisprednisoneIVIgrituximab
Type
Chapter
Information
Neuromuscular Disease
A Case-Based Approach
 , pp. 252 - 255
Publisher: Cambridge University Press
Print publication year: 2024

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References

Suggested Reading

Allenbach, Y, Benveniste, O, Stenzel, W, Boyer, O. Immune-mediated necrotizing myopathy: clinical features and pathogenesis. Nat Rev Rheumatol 2020;16(12):689–701. doi: 10.1038/s41584-020-00515-9. Epub 2020 Oct 22. PMID: 33093664.CrossRefGoogle ScholarPubMed
Allenbach, Y, Mammen, AL, Benveniste, O, Stenzel, W ; Immune-Mediated Necrotizing Myopathies Working Group. 224th ENMC International Workshop: clinico-sero-pathological classification of immune-mediated necrotizing myopathies Zandvoort, the Netherlands, 14-16 October 2016. Neuromuscul Disord 2018;28(1):87–99. doi: 10.1016/j.nmd.2017.09.016. Epub 2017 Oct 23. PMID: 29221629.CrossRefGoogle ScholarPubMed
Lim, J, Rietveld, A, De Bleecker, JL, et al. Seronegative patients form a distinctive subgroup of immune-mediated necrotizing myopathy. Neurol Neuroimmunol Neuroinflamm 2018;6(1):e513. doi: 10.1212/NXI.0000000000000513. PMID: 30345336; PMCID: PMC6192692.CrossRefGoogle Scholar

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