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  • Recurrent focal myositis developing into a generalised idiopathic inflammatory myopathy with anti-3-hydroxy-3-methylglutaryl-coenzyme A reductase autoantibodies

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Unusual association of diseases/symptoms
Case report
Recurrent focal myositis developing into a generalised idiopathic inflammatory myopathy with anti-3-hydroxy-3-methylglutaryl-coenzyme A reductase autoantibodies
  1. Johan Lim1,
  2. Leroy Ten Dam1,
  3. Paul A Baars2 and
  4. Anneke J Van der Kooi1
  1. 1 Neurology, Amsterdam UMC, University of Amsterdam, Amsterdam Neuroscience, Amsterdam, The Netherlands
  2. 2 Experimental Immunology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
  1. Correspondence to Dr Johan Lim; j.lim{at}amsterdamumc.nl

Abstract

We present the case of a 43-year-old woman with generalised idiopathic inflammatory myopathy (IIM) with anti-3-hydroxy-3-methylglutaryl-coenzyme A reductase (HMGCR) autoantibodies (Abs) that developed following recurrent focal myositis. Anti-HMGCR Abs are myositis-specific Abs that are associated with immune-mediated necrotising myopathy, a subtype of IIM that is characterised by relatively prominent and severe muscle involvement, generally necessitating multimodal immunosuppressant treatment. While earlier reports have described patients developing polymyositis following focal myositis, this is the first report to describe a patient developing IIM with anti-HMGCR Abs following focal myositis. Thus, clinicians should be aware of the possibility that focal myositis may develop into a generalised IIM and should instruct the patient and monitor the patient accordingly.

  • neuromuscular disease
  • muscle disease
  • rheumatology
  • neurology

https://doi.org/10.1136/bcr-2019-229787

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    Footnotes

    • Twitter @johanlim1990

    • Contributors We confirm that each individual named as an author meets the journal’s criteria for authorship. JL contributed to the conduct, reporting, conception and design, acquisition and interpretation of data, drafting/revising the manuscript and final approval. LTD contributed to the reporting, acquisition and interpretation of data, drafting/revising the manuscript and final approval. PAB contributed to the interpretation of data, drafting/revising the manuscript and final approval. AJVdK contributed to the conduct, reporting, conception and design, acquisition and interpretation of data, drafting/revising the manuscript and final approval.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Patient consent for publication Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.