An unusual presentation of inflammatory myopathy in a patient on natalizumab treatment for multiple sclerosis: A case report and review of myopathological classification of inflammatory myopathy
Journal Title: International Journal of Clinical Rheumatology - Year 2018, Vol 13, Issue 3
Abstract
Acquired immune and inflammatory myopathies (IIMs) are traditionally subdivided into dermatomyositis, polymyositis, inclusion body myositis (IBM) and necrotizing autoimmune myopathy (NAM). Our patient is a 38-year old female who had history of Multiple Sclerosis and was on Natalizumab. Almost a year later, she presented with acute proximal bilateral upper extremity weakness with elevated CPK. She was initially labeled as having ‘viral myositis’. Her subsequent two admissions demonstrated worsening of muscle weakness with dysphagia which was initially unresponsive to high dose of steroids. She had an EMG which showed irritative myopathy and a muscle biopsy which showed IMPP. She eventually responded to pulse dose of steroids and IVIG and Natalizumab was held. The temporal relationship between the development of inflammatory myopathy in our patient and subsequent improvement in her course after discontinuation of the drug suggests that natalizumab may have played a role in our patient’s disease and warrants further investigation and vigilance. In addition to the case report, we hope to elaborate on the myopathological descriptions increasingly being used to describe the IIMs and to explore the potential link between natalizumab and the onset of IIM in our patient.
Authors and Affiliations
Beenish Zulfiqar, Jacquelin Chua, Stacy Weinberg, Sobia Hassan
Keywords
Related Articles
- EP ID EP604508
- DOI -
- Views 35
- Downloads 0
A familial case of takayasu arteritis: HLA-related genetic susceptibility and efficacy of anti-TNFα treatment in two italian siblings
The aetiology of Takayasu Arteritis (TA) remains poorly understood. An autoimmune origin is the main hypothesis, suggesting an abnormal immune response against unknown antigens present on vessel walls. The genetic contri...
Disease activity and treatment patterns in rheumatoid arthritis in Qatar: Data from the Qatar rheumatoid arthritis registry
Introduction/Objectives: To describe disease activity and treatment patterns in patients with rheumatoid arthritis in Qatar. Methods: Registry data from consecutive patients who attended routine rheumatology outpatient...
High-field MRI exploration of the structural effects of cellular matrix™ on articular cartilage in knee osteoarthritis: A pilot study in 6 patients
Objective: To analyze the potential modulatory effect of Cellular Matrix, a new medical device designed for the one-step preparation of platelet-rich plasma in presence of hyaluronic acid, on the structure of articular c...
Synovial fluid level of vascular endothelial growth factor (VEGF) can predict functional status and radiological severity in patients with knee osteoarthritis (OA)
Aim of the work: Detection of serum and synovial fluid level of Vascular Endothelial Growth Factor (VEGF) in patients with knee osteoarthritis (OA) and to determine its relation to radiological severity and function stat...
Risk of upper gastrointestinal adverse events in Malaysian rheumatic patients on long-term non-steroidal antiinflammatory drugs
Background: Non-steroidal anti-inflammatory drug (NSAID)-induced upper gastrointestinal (GI) adverse events are well-described in the Western population but data is lacking in Asian patients. This study aims to describe...