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抗信号识别颗粒抗体阳性坏死性肌病伴继发性心肌病：首例经心肌活检和多模态影像学证实的病例

Anti-signal Recognition Particle Antibody-positive Necrotizing Myopathy with Secondary Cardiomyopathy: The First Myocardial Biopsy- and Multimodal Imaging-proven Case.

作者信息

Takeguchi-Kikuchi Shiori, Hayasaka Taiki, Katayama Takayuki, Kano Kohei, Takahashi Kae, Saito Tsukasa, Sawada Jun, Minoshima Akiho, Sakamoto Naka, Akasaka Kazumi, Miyokawa Naoyuki, Nishino Ichizo, Ishibashi-Ueda Hatsue, Hasebe Naoyuki

机构信息

Division of Neurology, First Department of Internal Medicine, Asahikawa Medical University, Japan.

Division of Cardiology, First Department of Internal Medicine, Asahikawa Medical University, Japan.

出版信息

Intern Med. 2019 Nov 1;58(21):3189-3194. doi: 10.2169/internalmedicine.2564-18. Epub 2019 Jul 10.

DOI:10.2169/internalmedicine.2564-18
PMID:31292376
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6875452/
Abstract

A 69-year-old Japanese woman was admitted to our hospital with progressive muscle weakness and dysphagia. She was taking pitavastatin for dyslipidemia. Her serum creatine kinase was 6,300 U/L. Pitavastatin was stopped, but her symptoms deteriorated, and cardiac congestion appeared. A muscle biopsy showed necrotizing myopathy (NM), and anti-signal recognition particle (SRP) antibody was positive. F-fluorodeoxyglucose-positron emission tomography showed an abnormal uptake, and magnetic resonance imaging showed abnormal gadolinium enhancement in the left ventricular wall. An endomyocardial biopsy revealed inflammatory cardiomyopathy. Steroid, tacrolimus, and intravenous immunoglobulins were effective against the symptoms. This is the first case of biopsy-proven secondary cardiomyopathy due to anti-SRP-positive NM.

摘要

一名69岁的日本女性因进行性肌肉无力和吞咽困难入院。她因血脂异常正在服用匹伐他汀。她的血清肌酸激酶为6300 U/L。停用了匹伐他汀，但她的症状恶化，出现了心脏充血。肌肉活检显示为坏死性肌病（NM），抗信号识别颗粒（SRP）抗体呈阳性。氟脱氧葡萄糖正电子发射断层扫描显示摄取异常，磁共振成像显示左心室壁钆增强异常。心内膜心肌活检显示为炎症性心肌病。类固醇、他克莫司和静脉注射免疫球蛋白对症状有效。这是首例经活检证实的抗SRP阳性NM所致继发性心肌病病例。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d742/6875452/4122425d6cd4/1349-7235-58-3189-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d742/6875452/45fc8a26aa98/1349-7235-58-3189-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d742/6875452/3dd12f3df93e/1349-7235-58-3189-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d742/6875452/b28152753394/1349-7235-58-3189-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d742/6875452/b0744cbf92b4/1349-7235-58-3189-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d742/6875452/4122425d6cd4/1349-7235-58-3189-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d742/6875452/45fc8a26aa98/1349-7235-58-3189-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d742/6875452/3dd12f3df93e/1349-7235-58-3189-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d742/6875452/b28152753394/1349-7235-58-3189-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d742/6875452/b0744cbf92b4/1349-7235-58-3189-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d742/6875452/4122425d6cd4/1349-7235-58-3189-g005.jpg

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