Thoracoabdominal muscle involvement in anti-PL-7 myopathy revealed by whole-body magnetic resonance imaging
| Autor: | Hitoshi Kubo, Yoshikazu Ugawa, Ayaka Nemoto, Nozomu Matsuda, Shunsuke Kobayashi, Shuzo Sato |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
myalgia Weakness Prednisolone Neurological examination Asymptomatic Amino Acyl-tRNA Synthetases 03 medical and health sciences 0302 clinical medicine Muscular Diseases medicine Humans Whole Body Imaging Muscle Skeletal Myopathy Myositis Abdominal Muscles Autoantibodies 030203 arthritis & rheumatology medicine.diagnostic_test business.industry Immunoglobulins Intravenous Magnetic resonance imaging Anatomy Thorax medicine.disease Magnetic Resonance Imaging Treatment Outcome medicine.anatomical_structure Cyclosporine Shoulder girdle Female Neurology (clinical) medicine.symptom business Immunosuppressive Agents 030217 neurology & neurosurgery |
| Zdroj: | Rinsho Shinkeigaku. 58:692-695 |
| ISSN: | 1882-0654 0009-918X |
| DOI: | 10.5692/clinicalneurol.cn-001201 |
| Popis: | A 33-year-old woman developed progressive weakness in the proximal limbs with myalgia and morning stiffness. Physical examination revealed low-grade fever, heliotrope eyelids and mechanic's hand. On neurological examination, she showed Medical Research Council grade 4 weakness in the shoulder girdle, proximal limb muscles, and grade 4 weakness in the abdominis muscle according to Daniels's scale. Laboratory tests revealed elevated serum creatine kinase (6,824 IU/l) and positive anti-PL-7 antibody. A needle electromyography study detected short motor unit potentials of myogenic pattern with abundant fibrillations and positive sharp waves. Whole-body MRI detected high intensity signals in the muscles of the shoulder girdle, proximal limbs, and thoracoabdominal trunk on short-tau inversion recovery sequence images. We diagnosed her as anti-PL-7 myopathy. After treatments with steroid, immunosuppressant, and immunoglobulin, her symptoms improved and abnormal MRI signals were normalized. Although MRI is known to be useful for detection of asymptomatic muscular inflammation in myositis, thoracoabdominal muscles are generally not covered in routine evaluation. To our knowledge, ours is the first case to detect acute inflammation of the thoracoabdominal muscles in antisynthetase syndrome. The present study suggests that whole-body MRI is useful for comprehensive evaluation of muscular involvement and longitudinal assessment for treatment outcomes. |
| Databáze: | OpenAIRE |
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