Severe myopathy in a patient with chronic neurological disease – diagnostic challenges
Polymyositis is a rare disease that belongs to the idiopathic inflammatory myopathies (IIMs) group, characterized by chronic muscle inflammation, and in rare cases a life-threatening condition due to extra-muscular involvement. Even though steroids constitute the building block of treatment of this...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Amaltea Medical Publishing House
2023-06-01
|
| Series: | Romanian Journal of Rheumatology |
| Subjects: | |
| Online Access: | https://rjr.com.ro/articles/2023.2/RJR_2023_2_Art-02.pdf |
| _version_ | 1827576811607818240 |
|---|---|
| author | Cristian-Mihai Ilie Suzana Popescu Sinziana Daia-Iliescu Ioana Saulescu Denisa Predeteanu Violeta-Claudia Bojinca Andra Balanescu Daniela Opris-Belinski |
| author_facet | Cristian-Mihai Ilie Suzana Popescu Sinziana Daia-Iliescu Ioana Saulescu Denisa Predeteanu Violeta-Claudia Bojinca Andra Balanescu Daniela Opris-Belinski |
| author_sort | Cristian-Mihai Ilie |
| collection | DOAJ |
| description | Polymyositis is a rare disease that belongs to the idiopathic inflammatory myopathies (IIMs) group, characterized by chronic muscle inflammation, and in rare cases a life-threatening condition due to extra-muscular involvement. Even though steroids constitute the building block of treatment of this disease, in severe cases, escalation treatment should be considered in order to obtain good clinical outcomes. We report a clinical case of a 22-year-old female who developed progressive severe systemic muscular weakness, dysphagia and dysphonia, accompanied by elevated serum muscle enzymes, positive myositis-specific antibodies, and muscle biopsy suggestive of inflammatory myopathy. The clinical features and laboratory results led us to the diagnosis of polymyositis. On additional laboratory tests the patient tested positive for Borrelia burgdorferi (Borrelia b) specific antibodies. Due to life-threatening organ involvement the immunosuppressive treatment, immunoglobulin intravenous infusion and pulse therapy with methylprednisolone were initiated and she needed nasogastric tube in order to be fed. Furthermore antibiotic treatment was administrated. The patient improved almost completely after 3 months of treatment. |
| first_indexed | 2024-03-08T21:17:51Z |
| format | Article |
| id | doaj.art-e4fe667c86444927be387eab18f07182 |
| institution | Directory Open Access Journal |
| issn | 1843-0791 2069-6086 |
| language | English |
| last_indexed | 2024-03-08T21:17:51Z |
| publishDate | 2023-06-01 |
| publisher | Amaltea Medical Publishing House |
| record_format | Article |
| series | Romanian Journal of Rheumatology |
| spelling | doaj.art-e4fe667c86444927be387eab18f071822023-12-21T15:21:41ZengAmaltea Medical Publishing HouseRomanian Journal of Rheumatology1843-07912069-60862023-06-01322657110.37897/RJR.2023.2.2Severe myopathy in a patient with chronic neurological disease – diagnostic challengesCristian-Mihai Ilie0Suzana Popescu1Sinziana Daia-Iliescu2Ioana Saulescu3Denisa Predeteanu4Violeta-Claudia Bojinca5Andra Balanescu6Daniela Opris-Belinski7Internal Medicine and Rheumatology Department, “Sf. Maria” Clinical Hospital, Bucharest, RomaniaInternal Medicine and Rheumatology Department, “Sf. Maria” Clinical Hospital, Bucharest, RomaniaInternal Medicine and Rheumatology Department, “Sf. Maria” Clinical Hospital, Bucharest, Romania; Internal Medicine and Rheumatology Department, “Carol Davila” University of Medicine and Pharmacy, Bucharest, RomaniaInternal Medicine and Rheumatology Department, “Sf. Maria” Clinical Hospital, Bucharest, Romania; Internal Medicine and Rheumatology Department, “Carol Davila” University of Medicine and Pharmacy, Bucharest, RomaniaInternal Medicine and Rheumatology Department, “Sf. Maria” Clinical Hospital, Bucharest, Romania; Internal Medicine and Rheumatology Department, “Carol Davila” University of Medicine and Pharmacy, Bucharest, RomaniaInternal Medicine and Rheumatology Department, “Sf. Maria” Clinical Hospital, Bucharest, Romania; Internal Medicine and Rheumatology Department, “Carol Davila” University of Medicine and Pharmacy, Bucharest, RomaniaInternal Medicine and Rheumatology Department, “Sf. Maria” Clinical Hospital, Bucharest, Romania; Internal Medicine and Rheumatology Department, “Carol Davila” University of Medicine and Pharmacy, Bucharest, RomaniaInternal Medicine and Rheumatology Department, “Sf. Maria” Clinical Hospital, Bucharest, Romania; Internal Medicine and Rheumatology Department, “Carol Davila” University of Medicine and Pharmacy, Bucharest, RomaniaPolymyositis is a rare disease that belongs to the idiopathic inflammatory myopathies (IIMs) group, characterized by chronic muscle inflammation, and in rare cases a life-threatening condition due to extra-muscular involvement. Even though steroids constitute the building block of treatment of this disease, in severe cases, escalation treatment should be considered in order to obtain good clinical outcomes. We report a clinical case of a 22-year-old female who developed progressive severe systemic muscular weakness, dysphagia and dysphonia, accompanied by elevated serum muscle enzymes, positive myositis-specific antibodies, and muscle biopsy suggestive of inflammatory myopathy. The clinical features and laboratory results led us to the diagnosis of polymyositis. On additional laboratory tests the patient tested positive for Borrelia burgdorferi (Borrelia b) specific antibodies. Due to life-threatening organ involvement the immunosuppressive treatment, immunoglobulin intravenous infusion and pulse therapy with methylprednisolone were initiated and she needed nasogastric tube in order to be fed. Furthermore antibiotic treatment was administrated. The patient improved almost completely after 3 months of treatment.https://rjr.com.ro/articles/2023.2/RJR_2023_2_Art-02.pdfpolymyositisimmunosuppressivecyclophosphamide |
| spellingShingle | Cristian-Mihai Ilie Suzana Popescu Sinziana Daia-Iliescu Ioana Saulescu Denisa Predeteanu Violeta-Claudia Bojinca Andra Balanescu Daniela Opris-Belinski Severe myopathy in a patient with chronic neurological disease – diagnostic challenges Romanian Journal of Rheumatology polymyositis immunosuppressive cyclophosphamide |
| title | Severe myopathy in a patient with chronic neurological disease – diagnostic challenges |
| title_full | Severe myopathy in a patient with chronic neurological disease – diagnostic challenges |
| title_fullStr | Severe myopathy in a patient with chronic neurological disease – diagnostic challenges |
| title_full_unstemmed | Severe myopathy in a patient with chronic neurological disease – diagnostic challenges |
| title_short | Severe myopathy in a patient with chronic neurological disease – diagnostic challenges |
| title_sort | severe myopathy in a patient with chronic neurological disease diagnostic challenges |
| topic | polymyositis immunosuppressive cyclophosphamide |
| url | https://rjr.com.ro/articles/2023.2/RJR_2023_2_Art-02.pdf |
| work_keys_str_mv | AT cristianmihaiilie severemyopathyinapatientwithchronicneurologicaldiseasediagnosticchallenges AT suzanapopescu severemyopathyinapatientwithchronicneurologicaldiseasediagnosticchallenges AT sinzianadaiailiescu severemyopathyinapatientwithchronicneurologicaldiseasediagnosticchallenges AT ioanasaulescu severemyopathyinapatientwithchronicneurologicaldiseasediagnosticchallenges AT denisapredeteanu severemyopathyinapatientwithchronicneurologicaldiseasediagnosticchallenges AT violetaclaudiabojinca severemyopathyinapatientwithchronicneurologicaldiseasediagnosticchallenges AT andrabalanescu severemyopathyinapatientwithchronicneurologicaldiseasediagnosticchallenges AT danielaoprisbelinski severemyopathyinapatientwithchronicneurologicaldiseasediagnosticchallenges |