Secondary cardiac involvement in anti-SRP-antibody-positive myopathy: an 87-year-old woman with heart failure symptoms as the first clinical presentation

Autor: Masahide Ijima, Shuta Toru, Ichizo Nishino, Mayumi Masumura, Satoshi Zeniya, Sawako Yada, Hiroaki Yokote, Ryota Amano, Toshiki Uchihara, Hidenobu Takei, Arika Hara
Rok vydání: 2019
Předmět:
medicine.medical_specialty
Myocarditis
Necrotizing myopathy
Non-sustained ventricular tachycardia
Colon carcinoma
Case Report
Comorbidity
030204 cardiovascular system & hematology
Gastroenterology
Pericardial effusion
lcsh:RC346-429
03 medical and health sciences
0302 clinical medicine
Muscular Diseases
Internal medicine
Medicine
Humans
Pericarditis
Myopathy
lcsh:Neurology. Diseases of the nervous system
Autoantibodies
Aged
80 and over
Heart Failure
Muscle biopsy
medicine.diagnostic_test
business.industry
Muscle weakness
Immunoglobulins
Intravenous
General Medicine
medicine.disease
Anti-signal recognition particle antibody
Methylprednisolone
Heart failure
Colonic Neoplasms
Female
Neurology (clinical)
medicine.symptom
business
Signal Recognition Particle
030217 neurology & neurosurgery
medicine.drug
Myopericarditis
Zdroj: BMC Neurology
BMC Neurology, Vol 20, Iss 1, Pp 1-5 (2020)
ISSN: 1471-2377
Popis: Background Necrotizing myopathy (NM) is defined by the dominant pathological feature of necrosis of muscle fibers without substantial lymphocytic inflammatory infiltration. Anti-signal recognition particle (SRP)-antibody-positive myopathy is related to NM. Anti-SRP-antibody-positive myopathy can comorbid with other disorders in some patients, however, comorbidity with malignant tumor and myopericarditis has still not been reported. Case presentation An 87-year-old woman with dyspnea on exertion and leg edema was referred to our hospital because of suspected heart failure and elevated serum creatine kinase level. Upon hospitalization, she developed muscle weakness predominantly in the proximal muscles. Muscle biopsy and immunological blood test led to the diagnosis of anti-SRP-antibody-positive myopathy. A colon carcinoma was also found and surgically removed. The muscle weakness remained despite the tumor resection and treatment with methylprednisolone. Cardiac screening revealed arrhythmia and diastolic dysfunction with pericardial effusion, which recovered with intravenous immunoglobulin (IVIg) treatment. Conclusions We reported the first case of anti-SRP-positive myopathy comorbid with colon carcinoma and myopericarditis. This case is rare in the point that heart failure symptoms were the first clinical presentation. The underlying mechanism is still not clear, however, physicians should be carefully aware of the neoplasm and cardiac involvement in anti-SRP-antibody positive-myopathy patients and should consider farther evaluation and management.
Databáze: OpenAIRE
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