tetano
Editor, Senior Moderator
BMC Neurol
. 2023 Mar 22;23(1):117.
doi: 10.1186/s12883-023-03170-1.
Immune-mediated necrotizing myopathy (NAM) related to SARS-Cov-2 infection: a case report
Azliza Ibrahim[SUP] 1 [/SUP], Wan Syamimee Wan Ghazali[SUP] 2 [/SUP], Anna Misyail[SUP] 3 [/SUP], Liyana Najwa[SUP] 3 [/SUP], Abdul Hanif Khan[SUP] 3 [/SUP], Wan Muhamad Amir[SUP] 4 [/SUP], Alvin Oliver Payus[SUP] 5 [/SUP], Loh Wei Chao[SUP] 3 [/SUP], Janudin Baharin[SUP] 3 [/SUP], Nor Shuhaila Shahril[SUP] 6 [/SUP], Suryati Mohd Yusoff[SUP] 7 [/SUP], Wan Aliaa[SUP] 3 [/SUP], Hoo Fan Kee[SUP] 3 [/SUP], Hamidon Basri[SUP] 3 [/SUP]
Affiliations
Abstract
Background: There is a growing body of evidence that severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) or COVID-19 infection is associated with the development of autoimmune diseases. A recent systematic review reported that the new-onset autoimmune disorders during or after COVID-19 infection included inflammatory myopathies such as immune-mediated necrotizing myopathies.
Case presentation: We described a 60-year-old man diagnosed with COVID-19 infection and later presented with a two-week history of myalgia, progressive limb weakness, and dysphagia. He had a Creatinine Kinase (CK) level of more than 10,000 U/L, was strongly positive for anti-signal recognition particle (SRP) and anti-Ro52 antibody, and a muscle biopsy revealed a paucity-inflammation necrotizing myopathy with randomly distributed necrotic fibers, which was consistent with necrotizing autoimmune myositis (NAM). He responded well clinically and biochemically to intravenous immunoglobulin, steroids and immunosuppressant and he was able to resume to his baseline.
Conclusion: SARS-CoV-2 may be associated with late-onset necrotizing myositis, mimicking autoimmune inflammatory myositis.
Keywords: COVID-19; Case report; Creatinine kinase; Myalgia; Necrotizing autoimmune myositis.
. 2023 Mar 22;23(1):117.
doi: 10.1186/s12883-023-03170-1.
Immune-mediated necrotizing myopathy (NAM) related to SARS-Cov-2 infection: a case report
Azliza Ibrahim[SUP] 1 [/SUP], Wan Syamimee Wan Ghazali[SUP] 2 [/SUP], Anna Misyail[SUP] 3 [/SUP], Liyana Najwa[SUP] 3 [/SUP], Abdul Hanif Khan[SUP] 3 [/SUP], Wan Muhamad Amir[SUP] 4 [/SUP], Alvin Oliver Payus[SUP] 5 [/SUP], Loh Wei Chao[SUP] 3 [/SUP], Janudin Baharin[SUP] 3 [/SUP], Nor Shuhaila Shahril[SUP] 6 [/SUP], Suryati Mohd Yusoff[SUP] 7 [/SUP], Wan Aliaa[SUP] 3 [/SUP], Hoo Fan Kee[SUP] 3 [/SUP], Hamidon Basri[SUP] 3 [/SUP]
Affiliations
- PMID: 36949469
- DOI: 10.1186/s12883-023-03170-1
Abstract
Background: There is a growing body of evidence that severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) or COVID-19 infection is associated with the development of autoimmune diseases. A recent systematic review reported that the new-onset autoimmune disorders during or after COVID-19 infection included inflammatory myopathies such as immune-mediated necrotizing myopathies.
Case presentation: We described a 60-year-old man diagnosed with COVID-19 infection and later presented with a two-week history of myalgia, progressive limb weakness, and dysphagia. He had a Creatinine Kinase (CK) level of more than 10,000 U/L, was strongly positive for anti-signal recognition particle (SRP) and anti-Ro52 antibody, and a muscle biopsy revealed a paucity-inflammation necrotizing myopathy with randomly distributed necrotic fibers, which was consistent with necrotizing autoimmune myositis (NAM). He responded well clinically and biochemically to intravenous immunoglobulin, steroids and immunosuppressant and he was able to resume to his baseline.
Conclusion: SARS-CoV-2 may be associated with late-onset necrotizing myositis, mimicking autoimmune inflammatory myositis.
Keywords: COVID-19; Case report; Creatinine kinase; Myalgia; Necrotizing autoimmune myositis.