抗3-羟基-3-甲基戊二酰辅酶A还原酶(HMGCR)免疫介导的坏死性肌病(IMNM)是一种神经肌肉疾病,表现为近端四肢和/或躯干肌肉无力,肌酸激酶升高(CK)。年轻且无症状的抗HMGCRIMNM患者非常罕见,治疗方案尚未建立。本案,一个没有任何肌肉症状的17岁女性,仅显示偶然发现的高CK血症。仔细检查后,包括肌肉活检和抗体搜索,她被诊断为抗HMGCRIMNM,甲氨蝶呤和持续静脉注射免疫球蛋白的初始治疗似乎是有效的。本病例是异常年轻的无症状抗HMGCRIMNM病例。诊断成功,导致治疗的早期引入。鉴于这个案子的进程,我们认为,上述抗体检测是横纹肌溶解症的诊断选择之一。
Anti-3-hydroxy-3-methylglutaryl-coenzyme A reductase (
HMGCR) immune-mediated necrotizing myopathy (IMNM) is a neuromuscular disorder that presents muscle weakness in proximal extremities and/or the trunk with an elevation of creatine kinase (CK). Young and asymptomatic anti-HMGCR IMNM patients are very rare and a treatment regimen has not been established. The present
case, a 17-year-old woman without any muscular symptoms, only showed hyperCKemia that was detected by chance. After close examinations, including a muscle biopsy and antibody search, she was diagnosed as anti-
HMGCR IMNM, and initial treatment with methotrexate and continuous intravenous immunoglobulin seemed to be effective. The present
case is the unusually young asymptomatic
case of anti-
HMGCR IMNM. The diagnosis was successfully made, leading to the early introduction of a treatment. Given the course of this
case, we believe that the preceding antibody testing is one of the diagnostic option for rhabdomyolysis.