Paraneoplastic Anti-3-hydroxy-3-methylglutary-coenzyme A Reductase Antibody-positive Immune-mediated Necrotizing Myopathy in a Patient with Uterine Cancer.

Abstract

We report the case of a 69-year-old woman with proximal limb muscle weakness, who received post-operative chemotherapy for uterine cancer. Her serum creatinine kinase level was high (10,779 mg/dL) and a muscle biopsy from her left biceps revealed various sizes of muscle fibers accompanied by necrotic and regenerating fibers. She was positive for anti-3 hydroxy-3-methylglutary-coenzyme A reductase (anti-HMGCR) antibodies, but negative for anti-signal recognition particle (anti-SRP) antibodies. She was diagnosed with immune-mediated necrotizing myopathy (IMNM) and treated with prednisolone. Our findings indicate that not only drug-induced myopathy but also paraneoplastic myopathy can be involved in the pathogenesis of IMNM.

• Authors: Atsushi Mizuma, Maiko Kouchi, Shizuka Netsu, Sachiko Yutani, Ruriko Kitao, Shigeaki Suzuki, Kenya Murata, Eiichiro Nagata, Shunya Takizawa
• Journal: Internal medicine (Tokyo, Japan) (Intern Med) Vol. 56 Issue 14 Pg. 1915-1918 ( 2017) ISSN: 1349-7235 [Electronic] Japan
• PMID: 28717093 (Publication Type: Case Reports, Journal Article)

Chemical References

• Autoantibodies
• Signal Recognition Particle
• Hydroxymethylglutaryl CoA Reductases

Topics

• Aged
• Autoantibodies (blood)
• Autoimmune Diseases (complications, immunology)
• Biopsy
• Female
• Humans
• Hydroxymethylglutaryl CoA Reductases (immunology)
• Muscle, Skeletal (pathology)
• Muscular Diseases (complications, immunology)
• Necrosis (pathology)
• Signal Recognition Particle (immunology)
• Uterine Neoplasms (complications, pathology)