Immune-mediated Necrotizing Myopathy With Increased Creatine Phosphokinase and Positive Signal Recognition Particle: A Case Report
Background: Knowledge about Immune-Mediated Necrotizing Myopathy (IMNM) has received significantly attention in recent years. In this study, we report a rare case of IMNM with increased Creatine Phosphokinase (CPK) and positive Signal Recognition Particle (SRP). Clinical Presentation and Interventio...
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| Format: | Article |
| Language: | English |
| Published: |
Guilan University of Medical Sciences
2022-07-01
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| Series: | Caspian Journal of Neurological Sciences |
| Subjects: | |
| Online Access: | http://cjns.gums.ac.ir/article-1-551-en.html |
| _version_ | 1818043746841788416 |
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| author | Seyed Mohammad Masoud Hojati Payam Saadat Shayan Alijanpour |
| author_facet | Seyed Mohammad Masoud Hojati Payam Saadat Shayan Alijanpour |
| author_sort | Seyed Mohammad Masoud Hojati |
| collection | DOAJ |
| description | Background: Knowledge about Immune-Mediated Necrotizing Myopathy (IMNM) has received
significantly attention in recent years. In this study, we report a rare case of IMNM with increased
Creatine Phosphokinase (CPK) and positive Signal Recognition Particle (SRP).
Clinical Presentation and Intervention: The case was a 67-year-old male patient referred to Firozgar
hospital affiliated to the Iran University of Medical Science, Tehran, Iran in June 2018 with a chief
complaint of pain in the proximal lower extremity. According to Medical Research Council Scale for
muscle strength, the motor function of proximal upper extremities was 4/5 and for the proximal of
the lower extremities, it was 3/5. Laboratory findings showed an increase in CPK, CK-MB, lactate
dehydrogenase, creatinine, alanine aminotransferase, aspartate aminotransferase and aldolase levels.
Six days after admission, autoantibody test was requested which showed positive SRP. In muscle
biopsy, the myopathic atrophy with multiple necrotic and many degenerative/regenerative fibers was
associated with mild endomysial fibrosis, and no inflammation was observed. Two g/kg dose of
Intravenous Immunoglobulin (IVIG) was administrated after diagnosis of IMNM. Prednisone 50
mg/day orally, calcium vitamin D daily, pantoprazole 40 mg/day, physiotherapy, and occupational
therapy were administrated for after discharge.
Conclusion: Reporting a case of anti-SRP associated IMNM and reviewing its pathophysiology,
diagnosis and treatment options can help increase the physicians’ knowledge of this rare and
debilitating condition. |
| first_indexed | 2024-12-10T09:07:07Z |
| format | Article |
| id | doaj.art-ff9ae0cacb654a4fa4605b84d1fdf76b |
| institution | Directory Open Access Journal |
| issn | 2423-4818 |
| language | English |
| last_indexed | 2024-12-10T09:07:07Z |
| publishDate | 2022-07-01 |
| publisher | Guilan University of Medical Sciences |
| record_format | Article |
| series | Caspian Journal of Neurological Sciences |
| spelling | doaj.art-ff9ae0cacb654a4fa4605b84d1fdf76b2022-12-22T01:55:08ZengGuilan University of Medical SciencesCaspian Journal of Neurological Sciences2423-48182022-07-0183192195Immune-mediated Necrotizing Myopathy With Increased Creatine Phosphokinase and Positive Signal Recognition Particle: A Case ReportSeyed Mohammad Masoud Hojati0Payam Saadat1Shayan Alijanpour2 Mobility Impairment Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran Clinical Research Development Unite of Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran Students Scientific Research Center, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran Background: Knowledge about Immune-Mediated Necrotizing Myopathy (IMNM) has received significantly attention in recent years. In this study, we report a rare case of IMNM with increased Creatine Phosphokinase (CPK) and positive Signal Recognition Particle (SRP). Clinical Presentation and Intervention: The case was a 67-year-old male patient referred to Firozgar hospital affiliated to the Iran University of Medical Science, Tehran, Iran in June 2018 with a chief complaint of pain in the proximal lower extremity. According to Medical Research Council Scale for muscle strength, the motor function of proximal upper extremities was 4/5 and for the proximal of the lower extremities, it was 3/5. Laboratory findings showed an increase in CPK, CK-MB, lactate dehydrogenase, creatinine, alanine aminotransferase, aspartate aminotransferase and aldolase levels. Six days after admission, autoantibody test was requested which showed positive SRP. In muscle biopsy, the myopathic atrophy with multiple necrotic and many degenerative/regenerative fibers was associated with mild endomysial fibrosis, and no inflammation was observed. Two g/kg dose of Intravenous Immunoglobulin (IVIG) was administrated after diagnosis of IMNM. Prednisone 50 mg/day orally, calcium vitamin D daily, pantoprazole 40 mg/day, physiotherapy, and occupational therapy were administrated for after discharge. Conclusion: Reporting a case of anti-SRP associated IMNM and reviewing its pathophysiology, diagnosis and treatment options can help increase the physicians’ knowledge of this rare and debilitating condition.http://cjns.gums.ac.ir/article-1-551-en.htmlmuscular diseasescreatine kinasesignal recognition particle |
| spellingShingle | Seyed Mohammad Masoud Hojati Payam Saadat Shayan Alijanpour Immune-mediated Necrotizing Myopathy With Increased Creatine Phosphokinase and Positive Signal Recognition Particle: A Case Report Caspian Journal of Neurological Sciences muscular diseases creatine kinase signal recognition particle |
| title | Immune-mediated Necrotizing Myopathy With Increased Creatine Phosphokinase and Positive Signal Recognition Particle: A Case Report |
| title_full | Immune-mediated Necrotizing Myopathy With Increased Creatine Phosphokinase and Positive Signal Recognition Particle: A Case Report |
| title_fullStr | Immune-mediated Necrotizing Myopathy With Increased Creatine Phosphokinase and Positive Signal Recognition Particle: A Case Report |
| title_full_unstemmed | Immune-mediated Necrotizing Myopathy With Increased Creatine Phosphokinase and Positive Signal Recognition Particle: A Case Report |
| title_short | Immune-mediated Necrotizing Myopathy With Increased Creatine Phosphokinase and Positive Signal Recognition Particle: A Case Report |
| title_sort | immune mediated necrotizing myopathy with increased creatine phosphokinase and positive signal recognition particle a case report |
| topic | muscular diseases creatine kinase signal recognition particle |
| url | http://cjns.gums.ac.ir/article-1-551-en.html |
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