• Internal medicine · May 2024

    Case Reports

    Immune-mediated Necrotizing Myopathy in a Patient with Microscopic Polyangiitis: A Case Report.

    • Daichi Umemoto, Yohei Kanzawa, Tomoko Nakamura, Ichizo Nishino, Shimpei Mizuki, Jun Ohnishi, Takahiro Nakajima, Naoto Ishimaru, and Saori Kinami.
    • Department of General Internal Medicine, Akashi Medical Center, Japan.
    • Intern. Med. 2024 May 15; 63 (10): 148514901485-1490.

    AbstractWe herein report a case of immune-mediated necrotizing myopathy (IMNM) in a patient with microscopic polyangiitis (MPA). A 77-year-old Japanese woman presented with a 2-day history of proximal muscle weakness and myalgia, with elevated serum creatinine kinase (CK) levels. Findings of a muscle biopsy were compatible with IMNM; however, anti-signal recognition particle (SRP) and anti-3-hydroxy-3-methylglutaryl-coenzyme A reductase (HMGCR) antibodies were negative. She also had peripheral neuropathy with elevated serum myeloperoxidase anti-neutrophil cytoplasmic antibody titers, leading to a diagnosis of MPA. IMNM can be a pathological result of MPA muscle involvement.

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