PDF(Pubmed)
Abstract：
Idiopathic inflammatory myopathy (IIM) represents a rare group of autoimmune conditions resulting in muscle weakness and includes polymyositis, dermatomyositis, immune-mediated necrotizing myopathy (IMNM), overlap myositis, and inclusion body myositis. Anti-3-hydroxy-3-methylglutaryl-CoA reductase (HMGCR) antibody IMNM represents a rare but increasingly recognized subtype of IIM. Here we report a case of a 65-year-old woman on rosuvastatin who presented with two months of progressive proximal muscle weakness, significant truncal weakness, and elevated creatine kinase concerning for rhabdomyolysis and inflammatory myopathy. The patient was eventually diagnosed on day 8 of her hospital stay with anti-HMGCR antibody IMNM after delayed testing for this specific myopathy. Increased awareness of this IIM subtype, as well as its risk factors and presenting features, might improve rapidity of testing and shorten hospital stays if the diagnosis is considered in the emergency department or early in the hospital course.
摘要：
特发性炎性肌病（IIM）代表一组罕见的自身免疫性疾病，导致肌肉无力，包括多发性肌炎，皮肌炎,免疫介导性坏死性肌病（IMNM），重叠肌炎,和包涵体肌炎。抗3-羟基-3-甲基戊二酰辅酶A还原酶（HMGCR）抗体IMNM代表了一种罕见但日益被认可的IIM亚型。在这里，我们报告一例65岁女性服用瑞舒伐他汀，出现两个月的进行性近端肌无力，显著的躯干无力，肌酸激酶升高与横纹肌溶解和炎性肌病有关。在延迟测试该特定肌病之后,患者最终在她住院的第8天被诊断为抗HMGCR抗体IMNM。增加了对这种IIM亚型的认识，以及其风险因素和呈现特征，如果在急诊科或住院早期考虑诊断，可能会提高检测速度并缩短住院时间。
