DOI: 10.12890/2015_000164

Immune-Mediated Necrotizing Myopathy: An Often Misdiagnosed Entity

Authors

  • Joana Almeida Espírito Santo Internal Medicine Department A, University Hospital Center of Coimbra, Coimbra
  • Rui Garcia Internal Medicine Department A, University Hospital Center of Coimbra, Coimbra
  • Benilde Barbosa Internal Medicine Department A, University Hospital Center of Coimbra, Coimbra
  • Olinda Rebelo Neuropathology Laboratory of the Neurology Department, University Hospital Center of Coimbra, Coimbra
  • José Pereira de Moura Internal Medicine Department A, University Hospital Center of Coimbra, Coimbra

joana_espiritosanto@hotmail.com

Keywords

Myopathy, Necrotizing myopathy, Immune-mediated necrotizing myopathy

Abstract

Immune-mediated necrotizing myopathies (IMNM) are recognized as a subgroup of idiopathic inflammatory myopathies (IIM). IMNM are defined based on a combination of clinical presentation and laboratory studies, requiring a specific myopathological pattern on muscle biopsy for diagnosis. The authors describe a case of a patient with necrotizing myopathy, thought to be immune mediated, highlighting the challenge of its differential diagnosis. As clinical assessment and diagnostic tools sometimes fail to determine whether a necrotizing myopathy is immune mediated, leading to misdiagnosis and a compromise of the optimal therapeutic approach, distinguishing between IMNM and other myopathies is crucial.

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References

  1. Hoogendijk JE, Amato AA, Lecky BR, Choy EH, Lundberg IE, Rose MR et al. 119th ENMC International Workshop: trial design in adult idiopathic inflammatory myopathies, with the exception of inclusion body myositis, 10–12 October 2003, Naarden, The Netherlands, Neuromusc Disord 2004;14:337–345.
  2. Allenbach Y, Benveniste O. Les myopathies nécrosantes acquises, Rev Med Intern 2013;34:363–368.
  3. Dalakas MC. Inflammatory muscle diseases: a critical review on pathogenesis and therapies, Curr Opin Pharmacol 2010;10:346–352.
  4. Hengstman GJ, ter Laak HJ, Vree Egberts WT, Lundberg IE, Moutsopoulos HM, Vencovsky J et al. Anti-signal recognition particle autoantibodies: marker of a necrotising myopathy, Ann Rheum Dis 2006;65:1635–1638.
  5. Drouot L, Allenbach Y, Jouen F, Charuel JL, Martinet J, Meyer A et al. Exploring necrotizing autoimmune myopathies with a novel immunoassay for anti-3-hydroxy-3-methyl-glutaryl-CoA reductase autoantibodies, Arthritis Res Ther 2014;16:R39.
  6. Brouwer R, Hengstman GJ, Vree Egberts W, Ehrfeld H, Bozic B, Ghirardello A et al. Autoantibody profiles in the sera of European patients with myositis, Ann Rheum Dis 2001;60:116–123.

Published

2015-01-16

Issue

Vol. 2 No. 1 (2015)

How to Cite

1.
Espírito Santo JA, Garcia R, Barbosa B, Rebelo O, Pereira de Moura J. Immune-Mediated Necrotizing Myopathy: An Often Misdiagnosed Entity. EJCRIM [Internet]. 2015 Jan. 16 [cited 2026 Nov. 4];2(1). Available from: https://ejcrim.com/index.php/ejcrim/article/view/164

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