• Internal medicine · Dec 2020

    Case Reports

    Recurrent HyperCKemia with Immunological Involvement of the Endomysial Capillaries in Neuromyelitis Optica.

    • Ryuta Kinno, Yuyuko Osakabe, Seiya Takahashi, Shinji Kurokawa, Yoshiyuki Owan, Jun Shimizu, Kenjiro Ono, and Yasuhiko Baba.
    • Department of Neurology, Showa University Fujigaoka Hospital, Japan.
    • Intern. Med. 2020 Dec 1; 59 (23): 3079-3083.

    AbstractA 55-year-old woman with neuromyelitis optica (NMO) had recurrent myalgias with hyperCKemia. A muscle biopsy suggested nonspecific myopathic changes. Regarding immunohistochemistry, the expression of both major histocompatibility complex class I and myxovirus resistance protein A was observed in the endomysial capillaries, suggesting immunological involvement of these capillaries, whereas both C5b9 (membrane attack complex) and aquaporin 4 immunofluorescence stainings were normal. The present findings led us to conclude that one possible mechanism for hyperCKemia in NMO underlying the immunological involvement of the endomysial capillaries was an as-yet-unidentified factor that triggered damage to the integrity of the sarcolemma and thereby cause CK leakage into the serum.

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