Tanaka Mariko, Gamou Naoki, Shizukawa Hirohiko, Tsuda Emiko, Shimohama Shun
Department of Neurology, Sapporo Kosei General Hospital.
Rinsho Shinkeigaku. 2016 Dec 28;56(12):862-865. doi: 10.5692/clinicalneurol.cn-000916. Epub 2016 Nov 25.
A 79 year-old female was admitted to our hospital because of high serum creatine kinase level together with proximal muscle weakness and pain on grasping. MRI revealed inflammatory changes in femoral muscles on both sides. Muscle biopsy showed size irregularity of muscle cells, and necrosis and regeneration of fibers. Study of antibodies was also consistent with the diagnostic criteria of anti-signal recognition particle (anti-SRP) antibody-positive myopathy. On admission, the patient required pericardiocentesis for the management of exudative pericarditis. Accompanying the aggravation of myositis, negative T wave in precordial leads on ECG, ventricular extrasystoles and non-sustained ventricular tachycardia were observed. These abnormalities were resolved with the improvement of myositis by immunosuppressive treatment. These observations suggest that the myopericarditis was associated with anti-SRP antibody-positive myopathy.
一名79岁女性因血清肌酸激酶水平升高、近端肌无力及抓握时疼痛入院。磁共振成像显示双侧股四头肌有炎症改变。肌肉活检显示肌细胞大小不均，纤维坏死及再生。抗体研究也符合抗信号识别颗粒（anti-SRP）抗体阳性肌病的诊断标准。入院时，患者因渗出性心包炎需要进行心包穿刺术。随着肌炎加重，心电图胸前导联出现T波倒置、室性早搏及非持续性室性心动过速。免疫抑制治疗使肌炎改善后，这些异常情况得以缓解。这些观察结果提示心肌心包炎与抗SRP抗体阳性肌病有关。
