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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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
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author Tamura, Takumi
Miyajima, Keisuke
Watanabe, Kazuki
Ito, Kazuki
Kin, Fumihiko
Okazaki, Ayako
Takashima, Yasuyo
Watanabe, Tomoyuki
Kawaguchi, Yoshitaka
Wakabayashi, Yasushi
Miyajima, Hiroaki
Maekawa, Yuichiro
author_facet Tamura, Takumi
Miyajima, Keisuke
Watanabe, Kazuki
Ito, Kazuki
Kin, Fumihiko
Okazaki, Ayako
Takashima, Yasuyo
Watanabe, Tomoyuki
Kawaguchi, Yoshitaka
Wakabayashi, Yasushi
Miyajima, Hiroaki
Maekawa, Yuichiro
author_sort Tamura, Takumi
collection PubMed
description 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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spelling pubmed-85456332021-10-29 An Autopsy Case of Antibody-negative Immune-mediated Necrotizing Myopathy with Severe Cardiac Involvement Tamura, Takumi Miyajima, Keisuke Watanabe, Kazuki Ito, Kazuki Kin, Fumihiko Okazaki, Ayako Takashima, Yasuyo Watanabe, Tomoyuki Kawaguchi, Yoshitaka Wakabayashi, Yasushi Miyajima, Hiroaki Maekawa, Yuichiro Intern Med Case Report 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. The Japanese Society of Internal Medicine 2021-04-12 2021-10-01 /pmc/articles/PMC8545633/ /pubmed/33840691 http://dx.doi.org/10.2169/internalmedicine.6355-20 Text en Copyright © 2021 by The Japanese Society of Internal Medicine https://creativecommons.org/licenses/by-nc-nd/4.0/The Internal Medicine is an Open Access journal distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. To view the details of this license, please visit (https://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Case Report
Tamura, Takumi
Miyajima, Keisuke
Watanabe, Kazuki
Ito, Kazuki
Kin, Fumihiko
Okazaki, Ayako
Takashima, Yasuyo
Watanabe, Tomoyuki
Kawaguchi, Yoshitaka
Wakabayashi, Yasushi
Miyajima, Hiroaki
Maekawa, Yuichiro
An Autopsy Case of Antibody-negative Immune-mediated Necrotizing Myopathy with Severe Cardiac Involvement
title An Autopsy Case of Antibody-negative Immune-mediated Necrotizing Myopathy with Severe Cardiac Involvement
title_full An Autopsy Case of Antibody-negative Immune-mediated Necrotizing Myopathy with Severe Cardiac Involvement
title_fullStr An Autopsy Case of Antibody-negative Immune-mediated Necrotizing Myopathy with Severe Cardiac Involvement
title_full_unstemmed An Autopsy Case of Antibody-negative Immune-mediated Necrotizing Myopathy with Severe Cardiac Involvement
title_short An Autopsy Case of Antibody-negative Immune-mediated Necrotizing Myopathy with Severe Cardiac Involvement
title_sort autopsy case of antibody-negative immune-mediated necrotizing myopathy with severe cardiac involvement
topic Case Report
url 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
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