An Autopsy Case of Antibody-negative Immune-mediated Necrotizing Myopathy with Severe Cardiac Involvement |
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| Authors: | Takumi Tamura Keisuke Miyajima Kazuki Watanabe Kazuki Ito Fumihiko Kin Ayako Okazaki Yasuyo Takashima Tomoyuki Watanabe Yoshitaka Kawaguchi Yasushi Wakabayashi Hiroaki Miyajima Yuichiro Maekawa |
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| Affiliation: | 1.Division of Cardiology, Internal Medicine III, Hamamatsu University School of Medicine, Japan; 2.Department of Cardiology, Seirei Mikatahara General Hospital, Japan; 3.Division of Neurology, Internal Medicine I, Hamamatsu University School of Medicine, Japan |
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| Abstract: | A 41-year-old man was admitted with a chief complaint of dyspnea. Echocardiography showed diffuse severe hypokinesis in the left ventricle. Although his heart failure improved, high creatine kinase levels persisted. A muscle biopsy of the biceps brachii showed necrotic and regenerating fibers along with positive findings for major histocompatibility complex class I and membrane attack complex. He was diagnosed with antibody-negative immune-mediated necrotizing myopathy (IMNM). Steroid therapy was started, but he died due to ventricular fibrillation. Autopsy findings revealed CD68-positive macrophages in the myocardium and quadriceps. To our knowledge, this is the first case of antibody-negative IMNM with cardiac involvement. |
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| Keywords: | immune-mediated necrotizing myopathy secondary cardiomyopathy cardiac magnetic resonance imaging autopsy |
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