Recurrent focal myositis developing into a generalised idiopathic inflammatory myopathy with anti-3-hydroxy-3-methylglutaryl-coenzyme A reductase autoantibodies.
Johan LimLeroy Ten DamPaul A BaarsAnneke J Van der KooiPublished in: BMJ case reports (2019)
We present the case of a 43-year-old woman with generalised idiopathic inflammatory myopathy (IIM) with anti-3-hydroxy-3-methylglutaryl-coenzyme A reductase (HMGCR) autoantibodies (Abs) that developed following recurrent focal myositis. Anti-HMGCR Abs are myositis-specific Abs that are associated with immune-mediated necrotising myopathy, a subtype of IIM that is characterised by relatively prominent and severe muscle involvement, generally necessitating multimodal immunosuppressant treatment. While earlier reports have described patients developing polymyositis following focal myositis, this is the first report to describe a patient developing IIM with anti-HMGCR Abs following focal myositis. Thus, clinicians should be aware of the possibility that focal myositis may develop into a generalised IIM and should instruct the patient and monitor the patient accordingly.
Keyphrases
- interstitial lung disease
- myasthenia gravis
- systemic sclerosis
- case report
- end stage renal disease
- late onset
- rheumatoid arthritis
- idiopathic pulmonary fibrosis
- systemic lupus erythematosus
- chronic kidney disease
- ejection fraction
- muscular dystrophy
- skeletal muscle
- peritoneal dialysis
- palliative care
- pain management
- drug induced
- electronic health record
- patient reported