autoimmune

自身免疫
  • 文章类型: Journal Article
    自身免疫性疾病(ADs)中的免疫失调是非霍奇金淋巴瘤(NHL)发展的危险因素。然而,潜在的机制还没有得到很好的理解。因此,这项回顾性研究旨在描述增加ADs患者NHL发展风险的临床和人口统计学因素.我们的研究利用了2016-2020年期间所有年龄>18岁患有NHL的成年患者的国家住院患者样本(NIS)的数据。我们将它们分为两个队列:一个有基础AD,一个没有基础AD。然后,我们比较了各种风险因素的调整后优势比(aOR)。发现0.9%的自身免疫性病例患有NHL,而0.7%的非自身免疫性病例患有NHL。在那些患有自身免疫性疾病的人中,各种因素影响淋巴瘤的存在,如个人化疗或放疗史,淋巴恶性肿瘤家族史,HIV感染,60-69岁高龄,亚洲和太平洋岛民种族和病毒性肝炎。具有自身免疫病症的NHL的增加的风险是充分确定的。研究还表明,与没有自身免疫性疾病的患者相比,这些患者的NHL总体预后较差。然而,关于传统NHL危险因素与潜在自身免疫相互作用的文献有限.因此,我们的研究揭示了较少研究的风险因素,如患者特征和合并症。
    Immune dysregulation in autoimmune diseases (ADs) is a risk factor for the development of Non-Hodgkin\'s lymphoma (NHL). However, the underlying mechanisms are not well understood. Hence, this retrospective study aims to describe the clinical and demographic factors that increase the risk of NHL development in patients with ADs. Our study utilised data from National Inpatient Sample (NIS) for the duration of 2016-2020 on all adult patients aged > 18 years who had NHL. We divided them into two cohorts: one with underlying ADs and one without underlying ADs. We then compared the adjusted odds ratios (aOR) of various risk factors. It was found that 0.9% of autoimmune cases had NHL, while 0.7% of non-autoimmune cases had NHL. Among those with autoimmune conditions, various factors influenced the presence of lymphoma, such as personal history of chemotherapy or radiation, family history of lymphoid malignancy, HIV infection, advanced age of 60-69 years, Asian and Pacific Islander ethnicity and viral hepatitis. The increased risk of NHL with autoimmune conditions is well established. Studies have also shown that these patients can overall have a poor prognosis from their NHL when compared to patients without autoimmune diseases. However, there is limited literature regarding the interplay of traditional NHL risk factors with underlying autoimmunity. Hence, our study sheds light on the lesser studied risk factors, such as patient characteristics and comorbidities.
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  • 文章类型: Journal Article
    背景:广泛的研究已经探索了肠道微生物群在多发性硬化症(MS)中的作用。然而,口腔和呼吸道微生物群落对MS的影响是一个新兴的研究领域。
    目的:我们的目的是回顾与鼻,口服,MS(PwMS)患者的肺部微生物群。
    方法:我们对PubMed的临床和临床前原始研究进行了叙述性回顾,探讨了鼻腔细菌或病毒成分之间的关系,肺,口腔微生物群和MS。此外,为了找到最初没有检索的相关研究,我们还搜索了相关评论论文中的参考文献,以及纳入研究中引用的参考文献。
    结论:在三个部分中仔细审查了13项研究:口腔微生物群(n=8),鼻腔微生物群(n=3),和肺微生物群(n=2),突出显示与健康对照(HCs)相比,PwMS的口腔和呼吸道微生物组发生了相当大的变化。与HCs相比,PwMS的口腔微生物群中的Aggregatibacter和链球菌等属含量较低,而葡萄球菌,Leptotrichia,梭杆菌,拟杆菌在PwMS中的丰度增加。此外,特定细菌的存在,包括血链球菌,在口腔微生物群中,有人建议影响爱泼斯坦-巴尔病毒的再激活,MS的既定风险因素与鼻腔微生物组相关的研究表明,特定的金黄色葡萄球菌毒素水平升高,以及PwMS中人类疱疹病毒(HHV)-6的鼻神经胶质细胞感染。在动物模型中对肺微生物组的新兴研究表明,操纵肺微生物组向产生脂多糖的细菌可能会抑制MS症状。这些发现为潜在的治疗策略开辟了道路。然而,进一步的研究对于充分理解微生物组和MS之间的复杂相互作用至关重要。这将有助于确定最有效的时机,细菌菌株,和调制技术。
    BACKGROUND: Extensive research has explored the role of gut microbiota in multiple sclerosis (MS). However, the impact of microbial communities in the oral cavity and respiratory tract on MS is an emerging area of investigation.
    OBJECTIVE: We aimed to review the current literature related to the nasal, oral, and lung microbiota in people with MS (PwMS).
    METHODS: We conducted a narrative review of clinical and preclinical original studies on PubMed that explored the relationship between the bacterial or viral composition of the nasal, lung, and oral microbiota and MS. Additionally, to find relevant studies not retrieved initially, we also searched for references in related review papers, as well as the references cited within the included studies.
    CONCLUSIONS: Thirteen studies were meticulously reviewed in three sections; oral microbiota (n = 8), nasal microbiota (n = 3), and lung microbiota (n = 2), highlighting considerable alterations in the oral and respiratory microbiome of PwMS compared to healthy controls (HCs). Genera like Aggregatibacter and Streptococcus were less abundant in the oral microbiota of PwMS compared to HCs, while Staphylococcus, Leptotrichia, Fusobacterium, and Bacteroides showed increased abundance in PwMS. Additionally, the presence of specific bacteria, including Streptococcus sanguinis, within the oral microbiota was suggested to influence Epstein-Barr virus reactivation, a well-established risk factor for MS. Studies related to the nasal microbiome indicated elevated levels of specific Staphylococcus aureus toxins, as well as nasal glial cell infection with human herpes virus (HHV)-6 in PwMS. Emerging research on lung microbiome in animal models demonstrated that manipulating the lung microbiome towards lipopolysaccharide-producing bacteria might suppress MS symptoms. These findings open avenues for potential therapeutic strategies. However, further research is crucial to fully understand the complex interactions between the microbiome and MS. This will help identify the most effective timing, bacterial strains, and modulation techniques.
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  • 文章类型: Journal Article
    他汀类药物是心血管疾病医疗管理的基石,然而,它们的功效在个体之间差异很大。在这篇评论中,我们概述了CD4+CD28nullT细胞扩增作为他汀类药物通过减少病理性炎症预防心血管事件的重要调节作用的证据.鉴于这种关系,我们认为,在临床和临床前研究中,应将T细胞谱视为患者特征,以检查他汀类药物在其他年龄和炎症相关病理中的疗效.我们讨论了这可能对在许多疾病过程中使用他汀类药物的研究产生的影响-特别是,痴呆和神经认知功能障碍-以及T细胞谱被用作类风湿关节炎中他汀类药物疗效的预测因子的潜力,老年痴呆症,和多发性硬化症。
    Statins are a cornerstone in the medical management of cardiovascular disease, yet their efficacy varies greatly between individuals. In this commentary, we outline evidence for the role of CD4+CD28null T-cell expansion as a critical moderator of the effects of statins in preventing cardiovascular events via the reduction of pathological inflammation. Given this relationship, we argue that T-cell profiles should be considered as a patient characteristic in clinical and pre-clinical studies examining statin efficacy in other age- and inflammation-related pathologies. We discuss the implications this may have for studies of statin use in numerous disease processes - notably, dementia and neurocognitive dysfunction - and the potential for T-cell profiles to be used as a prognosticator for statin efficacy in rheumatoid arthritis, Alzheimer\'s disease, and multiple sclerosis.
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  • 文章类型: Case Reports
    红斑天疱疮是一种罕见的自身免疫性大疱性皮肤病,组织学,和与红斑狼疮和天疱疮重叠的血清学特征。自身抗原是角质形成细胞中的桥粒蛋白3,桥粒蛋白1和桥粒粘附蛋白。当这些债券被破坏时,它导致角质形成细胞的棘皮松解,导致层之间的流体收集。因此,患者将在临床上出现小的松弛性大疱,结痂和鳞屑,主要在脂溢区。我们报告了一个21岁的女性出现多个角化过度斑块的病例,主要是在脂溢区,包括脸,胸部,和肘部。对患者进行了进一步评估,根据临床和实验室调查,诊断与抗双链脱氧核糖核酸(抗-dSDNA)和抗核抗体(ANA)阳性相关的天疱疮.然后使用免疫抑制剂治疗患者,整个过程在这个案例报告中已经详细说明了。
    Pemphigus erythematosus is an uncommon autoimmune bullous skin disorder with clinical, histological, and serological characteristics that overlap with lupus erythematosus and pemphigus foliaceus. The autoantigens are desmoglein 3, desmoglein 1, and desmosomal adhesion proteins in keratinocytes. When these bonds are disrupted, it causes acantholysis of keratinocytes, leading to the fluid collection between layers. Hence, the patient will present clinically with small flaccid bullae with crusting and scaling, mainly on the seborrheic areas. We report the case of a 21-year-old female presenting to us with multiple hyperkeratotic plaques, mainly on the seborrheic areas, including the face, chest, and elbows. The patient was evaluated further, and based on clinical and laboratory investigations, the diagnosis of pemphigus erythematosus associated with anti-double-stranded deoxyribonucleic acid (anti-dSDNA) and anti-nuclear antibody (ANA) positivity was made. The patient was then managed using immunosuppressant therapy, and the entire course has been detailed in this case report.
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  • 文章类型: Journal Article
    心血管疾病是一种高死亡率的慢性炎症性疾病。TNF-α是促炎的,与疾病有关,但是目前的药物有副作用。因此,迫切需要有效的抑制剂作为替代品。这项研究代表了TNF-α的结构-活性关系研究,从ChEMBL数据库中筛选。进行探索性数据分析以可视化不同生物活性基团的物理化学性质。提取的分子进行PubChem和SubStructure指纹图谱,并使用WEKA工具生成基于QSAR的随机森林(QSAR-RF)模型。QSAR随机森林模型是基于SubStructure指纹建立的,相关系数为0.992和0.716作为各自的十倍交叉验证分数。使用方差重要图(VIP)方法提取TNF-α抑制的重要特征。使用来自PubChem和ZINC数据库的分子验证基于子结构的QSAR-RF(SS-QSAR-RF)模型。生成的模型还预测了从对接研究中选择的分子的pIC50值,然后进行了时间步长为100ns的分子动力学模拟。通过虚拟反向药理学,我们从通过分子对接研究获得的前四个命中化合物中确定了主要的药物靶标。我们的分析包括一种综合的生物信息学方法来确定像EGRF这样的关键目标,HSP900A1、STAT3、PSEN1、AKT1和MDM2。Further,GO和KEGG通路分析确定了与hub基因相关的心血管疾病相关通路。然而,这项研究提供了有价值的见解,重要的是要注意,它缺乏实验应用。未来的研究可能会受益于进行体外和体内研究。
    Cardiovascular disease is a chronic inflammatory disease with high mortality rates. TNF-alpha is pro-inflammatory and associated with the disease, but current medications have adverse effects. Therefore, efficient inhibitors are urgently needed as alternatives. This study represents a structural-activity relationship investigation of TNF-alpha, curated from the ChEMBL database. Exploratory data analysis was performed to visualize the physicochemical properties of different bioactivity groups. The extracted molecules were subjected to PubChem and SubStructure fingerprints, and a QSAR-based Random Forest (QSAR-RF) model was generated using the WEKA tool. The QSAR random Forest model was built based on the SubStructure fingerprint with a correlation coefficient of 0.992 and 0.716 as the respective tenfold cross-validation scores. The variance important plot (VIP) method was used to extract the important features for TNF-alpha inhibition. The Substructure-based QSAR-RF (SS-QSAR-RF) model was validated using molecules from PubChem and ZINC databases. The generated model also predicts the pIC50 value of the molecules selected from the docking study followed by molecular dynamic simulation with the time step of 100 ns. Through virtual reverse pharmacology, we determined the main drug targets from the top four hit compounds obtained via molecular docking study. Our analysis included an integrated bioinformatics approach to pinpoint crucial targets like EGRF, HSP900A1, STAT3, PSEN1, AKT1, and MDM2. Further, GO and KEGG pathways analysis identified relevant cardiovascular disease-related pathways for the hub gene involved. However, this study provides valuable insights, it is important to note that it lacks experimental application. Future research may benefit from conducting in-vitro and in-vivo studies.
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  • 文章类型: Case Reports
    抗甘氨酸受体(抗GlyR)抗体介导多种免疫相关疾病。本研究旨在总结抗GlyR抗体相关疾病的临床特征,以提高我们对其的认识。
    通过收集甘氨酸受体(GlyR)抗体阳性的住院患者的临床信息,本研究报道了一名新的GlyR抗体阳性患者的临床特征.为了获得关于抗GlyR抗体相关疾病的更多信息,本研究中新报道的病例和以前发表的病例的临床数据和结果被合并和分析.
    在这项研究中发现了一个新的抗GlyR抗体相关的进行性脑脊髓炎,伴有僵硬和肌阵挛症(PERM)。一名20岁的男性,脑脊液抗GlyR抗体仅阳性,一线免疫疗法预后良好。文献回顾表明,抗GlyR抗体相关疾病的常见临床表现包括PERM或僵人综合征(SPS)(n=179,50.1%)。癫痫发作(n=94,26.3%),和其他神经系统疾病(n=84,24.5%)。其他神经系统问题包括脱髓鞘,炎症,小脑共济失调和运动障碍,脑炎,急性精神病,认知障碍或痴呆,乳糜泻,帕金森病,神经性疼痛和异常性疼痛,类固醇反应性耳聋,hemibalism/tic,喉肌张力障碍,全身无力包括呼吸肌。PERM/SPS组对免疫疗法的反应优于其他组。
    研究结果表明在抗GlyR抗体相关疾病中存在多种临床表型。常见的临床表型包括PERM,SPS,癫痫发作,和副肿瘤疾病。患有RERM/SPS的患者对免疫疗法反应良好。
    UNASSIGNED: Antiglycine receptor (anti-GlyR) antibody mediates multiple immune-related diseases. This study aimed to summarize the clinical features to enhance our understanding of anti-GlyR antibody-related disease.
    UNASSIGNED: By collecting clinical information from admitted patients positive for glycine receptor (GlyR) antibody, the clinical characteristics of a new patient positive for GlyR antibody were reported in this study. To obtain additional information regarding anti-GlyR antibody-linked illness, clinical data and findings on both newly reported instances in this study and previously published cases were merged and analyzed.
    UNASSIGNED: A new case of anti-GlyR antibody-related progressive encephalomyelitis with rigidity and myoclonus (PERM) was identified in this study. A 20-year-old man with only positive cerebrospinal fluid anti-GlyR antibody had a good prognosis with first-line immunotherapy. The literature review indicated that the common clinical manifestations of anti-GlyR antibody-related disease included PERM or stiff-person syndrome (SPS) (n = 179, 50.1%), epileptic seizure (n = 94, 26.3%), and other neurological disorders (n = 84, 24.5%). Other neurological issues included demyelination, inflammation, cerebellar ataxia and movement disorders, encephalitis, acute psychosis, cognitive impairment or dementia, celiac disease, Parkinson\'s disease, neuropathic pain and allodynia, steroid-responsive deafness, hemiballism/tics, laryngeal dystonia, and generalized weakness included respiratory muscles. The group of PERM/SPS exhibited a better response to immunotherapy than others.
    UNASSIGNED: The findings suggest the presence of multiple clinical phenotypes in anti-GlyR antibody-related disease. Common clinical phenotypes include PERM, SPS, epileptic seizure, and paraneoplastic disease. Patients with RERM/SPS respond well to immunotherapy.
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  • 文章类型: Journal Article
    背景:在1型糖尿病(T1DM)患者中,自身免疫性疾病发病率的增加凸显了人类白细胞抗原(HLA)单倍型对其发展的影响。本研究旨在确定T1DM患者自身免疫性疾病的遗传易感性。包括甲状腺疾病和乳糜泻,并探讨其与维生素D缺乏的相关性。
    方法:进行了一项涉及36名T1DM儿童的横断面研究。对HLAA进行了分型,B,C,DP,DR,和DQ基因座。回归分析将DR-DQ单倍型与T1DM及相关病症联系起来。
    结果:最常见的易感等位基因和单倍型是HLA-DR3(70.27%),DQ2(70.27%),DR3-DQ2(70.27%),DQB1*02:01(70.27%),A02(54.05%),而最普遍的保护等位基因是DPB1*04:01(52.63%)。在抗甲状腺过氧化物酶抗体阳性和不存在保护性等位基因之间观察到正相关(DPB1*04:02,p=0.036;DPB1*04:01,p=0.002)。在不存在DPB1*04:01和抗甲状腺球蛋白抗体之间发现关联(p=0.03)。HLA等位基因DPB1*03:01与维生素D缺乏相关(p=0.021)。阳性抗转谷氨酰胺酶抗体与C03:03(p=0.026)和DRB1*04:01-DQA1*03-DQB1*03:01(p<0.0001)和缺乏DQA1*01:03-DQB1*06:03-DRB1*13:01(p<0.0001)相关。
    结论:易感T1DM单倍型与抗谷氨酰胺转氨酶和抗甲状腺抗体的存在有关,表明自身免疫性疾病的遗传易感性。
    BACKGROUND: The increasing incidence of autoimmune diseases in type 1 diabetes mellitus (T1DM) patients highlights the influence of human leukocyte antigen (HLA) haplotypes on their development. This study aims to determine genetic predisposition to autoimmune diseases in T1DM patients, including thyroid disease and celiac diseases, and explore its correlation with vitamin D deficiency.
    METHODS: A cross-sectional study involving thirty-six T1DM children was conducted. Typing was performed for the HLA A, B, C, DP, DR, and DQ loci. Regression analysis linked DR-DQ haplotypes to T1DM and the associated conditions.
    RESULTS: The most frequent predisposing alleles and haplotypes were HLA-DR3 (70.27%), DQ2 (70.27%), DR3-DQ2 (70.27%), DQB1*02:01 (70.27%), A02 (54.05%), whereas the most prevalent protecting allele was DPB1*04:01 (52.63%). Positive correlations were observed between positive anti-thyroid peroxidase antibodies and the absence of protective alleles (DPB1*04:02, p = 0.036; DPB1*04:01, p = 0.002). Associations were found between the absence of DPB1*04:01 and anti-thyroglobulin antibodies (p = 0.03). HLA allele DPB1*03:01 was linked with vitamin D deficiency (p = 0.021). Positive anti-transglutaminase antibodies correlated with C03:03 (p = 0.026) and DRB1*04:01-DQA1*03-DQB1*03:01 (p < 0.0001) and the lack of DQA1*01:03-DQB1*06:03-DRB1*13:01 (p < 0.0001).
    CONCLUSIONS: The predisposing T1DM haplotypes were associated with the presence of anti-transglutaminase and anti-thyroid antibodies, indicating a genetic predisposition to autoimmune diseases.
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  • 文章类型: Journal Article
    在过去的几年里,人们对大麻二酚(CBD)治疗各种疾病如疼痛的兴趣越来越大,焦虑,失眠,和炎症。CBD作为抗炎疗法的潜力已经到来,在某种程度上,从其在自身免疫性疾病中抑制神经炎症的能力来看,比如多发性硬化症的小鼠模型,实验性自身免疫性脑脊髓炎(EAE)。CBD使用的增加强烈表明,有必要进行更多的研究来阐明其安全性和有效性,并确定其作用机制。因此,我们进行了两项独立的研究。在第一,进行在存在和不存在CBD的情况下经历EAE的雌性小鼠的脑的RNA测序(RNA-Seq)分析以鉴定当有效时介导其神经保护作用的潜在基因。在第二个,我们在没有免疫刺激的情况下,在接受CBD治疗的雄性和雌性小鼠中评估了一些相同的基因。一起,这些数据表明,CBD适度增加催产素(Oxt)和精氨酸加压素(加压素,Avp)小鼠大脑中的基因表达,不管是否有活动性炎症。总的来说,这些数据提示Oxt和Avp可能作为CBD暴露的生物标志物.
    Over the last several years, there has been increased interest in cannabidiol (CBD) to treat various ailments such as pain, anxiety, insomnia, and inflammation. The potential for CBD as an anti-inflammatory therapy has come, in part, from its demonstrated ability to suppress neuroinflammation in autoimmune diseases, such as the mouse model of multiple sclerosis, experimental autoimmune encephalomyelitis (EAE). The increased use of CBD strongly suggests that more research is necessary to elucidate its safety and efficacy and determine the mechanisms by which it acts. Thus, we conducted two separate studies. In the first, RNA sequencing (RNA-Seq) analysis of brains of female mice undergoing EAE in the presence and absence of CBD was conducted to identify potential genes that mediated its neuroprotective effects when efficacious. In the second, we assessed some of the same genes in male and female mice treated with CBD in the absence of an immune stimulus. Together, these data showed that CBD modestly increased oxytocin (Oxt) and arginine vasopressin (vasopressin, Avp) gene expression in the brains of mice, regardless of whether there was active inflammation. Overall, these data suggest that Oxt and Avp might act as biomarkers for CBD exposure.
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  • 文章类型: Journal Article
    “catatonia”一词是由德国精神病学家KarlKahlbaum于1874年提出的。尽管历史上与精神分裂症有关,紧张症表现出多种表型,并已在各种医学和神经精神疾病中观察到。其固有的运动特征以及与运动机能减退和运动亢进现象的关联将卡顿强症置于运动障碍的范围内。尽管150多年来在精神病学文献中出现了卡通症,关于其病因的许多空白和争议仍然存在,现象学,诊断标准,和治疗。国际疾病分类(ICD-11)和精神疾病诊断和统计手册(DSM-5)的当前版本要求临床医生识别15(ICD-11)或12(DSM-5)的任何三个体征用于诊断紧张症。僵症和蜡状柔韧性是唯一对诊断具有高特异性的运动特征。我们强调了紧张症作为一种运动障碍的差距和争议,强调缺乏明确的定义,并讨论各种紧张性体征描述中的不一致之处。我们建议探索类似于肌张力障碍和震颤的双轴分类框架,以鼓励对潜在病因的评估并指导治疗决策以改善这些患者的预后。©2024国际帕金森和运动障碍协会。
    The term \"catatonia\" was introduced by German psychiatrist Karl Kahlbaum in 1874. Although historically tied to schizophrenia, catatonia exhibits a diverse range of phenotypes and has been observed in various medical and neuropsychiatric conditions. Its intrinsic movement characteristics and association with hypokinetic and hyperkinetic phenomenologies place catatonia within the purview of movement disorders. Despite the presence of catatonia in psychiatry literature for over 150 years, many gaps and controversies persist regarding its etiopathogenesis, phenomenology, diagnostic criteria, and treatment. The current versions of the International Classification of Diseases (ICD-11) and the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) require clinicians to identify any three signs of 15 (ICD-11) or 12 (DSM-5) for the diagnosis of catatonia. Catalepsy and waxy flexibility are the only motor features with high specificity for the diagnosis. We highlight the gaps and controversies in catatonia as a movement disorder, emphasize the lack of a clear definition, and discuss the inconsistencies in the description of various catatonic signs. We propose the exploration of a bi-axial classification framework similar to that used for dystonia and tremor to encourage the evaluation of underlying etiologies and to guide therapeutic decisions to improve the outcome of these patients. © 2024 International Parkinson and Movement Disorder Society.
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  • 文章类型: Case Reports
    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。
    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.
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