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

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. 18F-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.
Authors	Shiori Takeguchi-Kikuchi, Taiki Hayasaka, Takayuki Katayama, Kohei Kano, Kae Takahashi, Tsukasa Saito, Jun Sawada, Akiho Minoshima, Naka Sakamoto, Kazumi Akasaka, Naoyuki Miyokawa, Ichizo Nishino, Hatsue Ishibashi-Ueda, Naoyuki Hasebe
Journal	Internal medicine (Tokyo, Japan) (Intern Med) Vol. 58 Issue 21 Pg. 3189-3194 (Nov 01 2019) ISSN: 1349-7235 [Electronic] Japan
PMID	31292376 (Publication Type: Case Reports, Journal Article)
Chemical References	Autoantibodies Contrast Media Immunoglobulins, Intravenous Immunosuppressive Agents Signal Recognition Particle Gadolinium Tacrolimus
Topics	Aged Autoantibodies (blood) Biopsy Cardiomyopathies (diagnostic imaging, etiology) Contrast Media Echocardiography Female Gadolinium Humans Immunoglobulins, Intravenous (therapeutic use) Immunosuppressive Agents (therapeutic use) Magnetic Resonance Imaging Multimodal Imaging Muscle Weakness (pathology) Muscle, Skeletal (pathology) Muscular Diseases (complications, diagnostic imaging, pathology) Positron Emission Tomography Computed Tomography Signal Recognition Particle (immunology) Tacrolimus (therapeutic use)

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