Ibrahim Azliza, Ghazali Wan Syamimee Wan, Misyail Anna, Najwa Liyana, Khan Abdul Hanif, Amir Wan Muhamad, Payus Alvin Oliver, Chao Loh Wei, Baharin Janudin, Shahril Nor Shuhaila, Yusoff Suryati Mohd, Aliaa Wan, Kee Hoo Fan, Basri Hamidon
Department of Neurology, Hospital Pengajar Universiti Putra Malaysia, Kuala Lumpur, Malaysia.
Department of Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Kuala Lumpur, Malaysia.
BMC Neurol. 2023 Mar 22;23(1):117. doi: 10.1186/s12883-023-03170-1.
There is a growing body of evidence that severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) or COVID-19 infection is associated with the development of autoimmune diseases. A recent systematic review reported that the new-onset autoimmune disorders during or after COVID-19 infection included inflammatory myopathies such as immune-mediated necrotizing myopathies.
We described a 60-year-old man diagnosed with COVID-19 infection and later presented with a two-week history of myalgia, progressive limb weakness, and dysphagia. He had a Creatinine Kinase (CK) level of more than 10,000 U/L, was strongly positive for anti-signal recognition particle (SRP) and anti-Ro52 antibody, and a muscle biopsy revealed a paucity-inflammation necrotizing myopathy with randomly distributed necrotic fibers, which was consistent with necrotizing autoimmune myositis (NAM). He responded well clinically and biochemically to intravenous immunoglobulin, steroids and immunosuppressant and he was able to resume to his baseline.
SARS-CoV-2 may be associated with late-onset necrotizing myositis, mimicking autoimmune inflammatory myositis.
越来越多的证据表明，严重急性呼吸综合征冠状病毒2（SARS-CoV-2）或新型冠状病毒肺炎（COVID-19）感染与自身免疫性疾病的发生有关。最近一项系统评价报告称，COVID-19感染期间或之后新发的自身免疫性疾病包括免疫介导的坏死性肌病等炎性肌病。
我们描述了一名60岁男性，诊断为COVID-19感染，随后出现了两周的肌痛、进行性肢体无力和吞咽困难病史。他的肌酸激酶（CK）水平超过10000 U/L，抗信号识别颗粒（SRP）和抗Ro52抗体呈强阳性，肌肉活检显示为炎症较少的坏死性肌病，坏死纤维随机分布，这与坏死性自身免疫性肌炎（NAM）一致。他在临床和生化方面对静脉注射免疫球蛋白、类固醇和免疫抑制剂反应良好，能够恢复到基线状态。
SARS-CoV-2可能与迟发性坏死性肌炎有关，类似于自身免疫性炎性肌炎。
