An Autopsy Case of Antibody-negative Immune-mediated Necrotizing Myopathy with Severe Cardiac Involvement

A 41-year-old man was admitted with a chief complaint of dyspnea. Echocardiography showed diffuse severe hypokinesis in the left ventricle. Although his heart failure improved, high creatine kinase levels persisted. A muscle biopsy of the biceps brachii showed necrotic and regenerating fibers along...

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Detalles Bibliográficos
Autores principales: Tamura, Takumi, Miyajima, Keisuke, Watanabe, Kazuki, Ito, Kazuki, Kin, Fumihiko, Okazaki, Ayako, Takashima, Yasuyo, Watanabe, Tomoyuki, Kawaguchi, Yoshitaka, Wakabayashi, Yasushi, Miyajima, Hiroaki, Maekawa, Yuichiro
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Japanese Society of Internal Medicine 2021
Materias:
Case Report
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8545633/
https://www.ncbi.nlm.nih.gov/pubmed/33840691
http://dx.doi.org/10.2169/internalmedicine.6355-20
Descripción
Sumario:A 41-year-old man was admitted with a chief complaint of dyspnea. Echocardiography showed diffuse severe hypokinesis in the left ventricle. Although his heart failure improved, high creatine kinase levels persisted. A muscle biopsy of the biceps brachii showed necrotic and regenerating fibers along with positive findings for major histocompatibility complex class I and membrane attack complex. He was diagnosed with antibody-negative immune-mediated necrotizing myopathy (IMNM). Steroid therapy was started, but he died due to ventricular fibrillation. Autopsy findings revealed CD68-positive macrophages in the myocardium and quadriceps. To our knowledge, this is the first case of antibody-negative IMNM with cardiac involvement.

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