Prominent Asymmetric Muscle Weakness and Atrophy in Seronegative Immune-Mediated Necrotizing Myopathy

Immune-mediated necrotizing myopathy, a new subgroup of inflammatory myopathies, usually begins with subacute onset of symmetrical proximal muscle weakness. A 35-year-old male presented with severe asymmetric iliopsoas atrophy and low back pain with a previous history of left lower extremity weaknes...

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Autores principales:	Sunha Park, Dae-Hyun Jang, Jae-Min Kim, Nara Yoon
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	immune-mediated necrotizing myopathy inflammatory myopathy asymmetric muscle involvement Medicine (General) R5-920
Acceso en línea:	https://doaj.org/article/00207d0f2ee749ac9fd8da801d4e5c61
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spelling	oai:doaj.org-article:00207d0f2ee749ac9fd8da801d4e5c612021-11-25T17:21:18ZProminent Asymmetric Muscle Weakness and Atrophy in Seronegative Immune-Mediated Necrotizing Myopathy10.3390/diagnostics111120642075-4418https://doaj.org/article/00207d0f2ee749ac9fd8da801d4e5c612021-11-01T00:00:00Zhttps://www.mdpi.com/2075-4418/11/11/2064https://doaj.org/toc/2075-4418Immune-mediated necrotizing myopathy, a new subgroup of inflammatory myopathies, usually begins with subacute onset of symmetrical proximal muscle weakness. A 35-year-old male presented with severe asymmetric iliopsoas atrophy and low back pain with a previous history of left lower extremity weakness. Although his first left lower extremity weakness occurred 12 years ago, he did not receive a clear diagnosis. Magnetic resonance imaging of both thigh muscles showed muscle edema and contrast enhancement in patch patterns, and the left buttock and thigh muscles were more atrophied compared to the right side. Serum creatine kinase levels were elevated, and serologic testings were all negative. Genetic testing using a targeted gene-sequencing panel for neuromuscular disease including myopathy identified no pathogenic variants. Muscle biopsy on the right vastus lateralis showed scattered myofiber necrosis with phagocytosis and an absence of prominent inflammatory cells, consistent with seronegative necrotizing myopathy. Thus, unusual asymmetric muscle weakness and atrophy can be a manifestation of inflammatory myopathy.Sunha ParkDae-Hyun JangJae-Min KimNara YoonMDPI AGarticleimmune-mediated necrotizing myopathyinflammatory myopathyasymmetric muscle involvementMedicine (General)R5-920ENDiagnostics, Vol 11, Iss 2064, p 2064 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	immune-mediated necrotizing myopathy inflammatory myopathy asymmetric muscle involvement Medicine (General) R5-920
spellingShingle	immune-mediated necrotizing myopathy inflammatory myopathy asymmetric muscle involvement Medicine (General) R5-920 Sunha Park Dae-Hyun Jang Jae-Min Kim Nara Yoon Prominent Asymmetric Muscle Weakness and Atrophy in Seronegative Immune-Mediated Necrotizing Myopathy
description	Immune-mediated necrotizing myopathy, a new subgroup of inflammatory myopathies, usually begins with subacute onset of symmetrical proximal muscle weakness. A 35-year-old male presented with severe asymmetric iliopsoas atrophy and low back pain with a previous history of left lower extremity weakness. Although his first left lower extremity weakness occurred 12 years ago, he did not receive a clear diagnosis. Magnetic resonance imaging of both thigh muscles showed muscle edema and contrast enhancement in patch patterns, and the left buttock and thigh muscles were more atrophied compared to the right side. Serum creatine kinase levels were elevated, and serologic testings were all negative. Genetic testing using a targeted gene-sequencing panel for neuromuscular disease including myopathy identified no pathogenic variants. Muscle biopsy on the right vastus lateralis showed scattered myofiber necrosis with phagocytosis and an absence of prominent inflammatory cells, consistent with seronegative necrotizing myopathy. Thus, unusual asymmetric muscle weakness and atrophy can be a manifestation of inflammatory myopathy.
format	article
author	Sunha Park Dae-Hyun Jang Jae-Min Kim Nara Yoon
author_facet	Sunha Park Dae-Hyun Jang Jae-Min Kim Nara Yoon
author_sort	Sunha Park
title	Prominent Asymmetric Muscle Weakness and Atrophy in Seronegative Immune-Mediated Necrotizing Myopathy
title_short	Prominent Asymmetric Muscle Weakness and Atrophy in Seronegative Immune-Mediated Necrotizing Myopathy
title_full	Prominent Asymmetric Muscle Weakness and Atrophy in Seronegative Immune-Mediated Necrotizing Myopathy
title_fullStr	Prominent Asymmetric Muscle Weakness and Atrophy in Seronegative Immune-Mediated Necrotizing Myopathy
title_full_unstemmed	Prominent Asymmetric Muscle Weakness and Atrophy in Seronegative Immune-Mediated Necrotizing Myopathy
title_sort	prominent asymmetric muscle weakness and atrophy in seronegative immune-mediated necrotizing myopathy
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/00207d0f2ee749ac9fd8da801d4e5c61
work_keys_str_mv	AT sunhapark prominentasymmetricmuscleweaknessandatrophyinseronegativeimmunemediatednecrotizingmyopathy AT daehyunjang prominentasymmetricmuscleweaknessandatrophyinseronegativeimmunemediatednecrotizingmyopathy AT jaeminkim prominentasymmetricmuscleweaknessandatrophyinseronegativeimmunemediatednecrotizingmyopathy AT narayoon prominentasymmetricmuscleweaknessandatrophyinseronegativeimmunemediatednecrotizingmyopathy
_version_	1718412447851741184

Prominent Asymmetric Muscle Weakness and Atrophy in Seronegative Immune-Mediated Necrotizing Myopathy

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