PT  - JOURNAL ARTICLE
AU  - Parizher, Gary
AU  - Brown, Timothy J
AU  - Hon, Mary
AU  - Joerns, Elena K
AU  - Zuo, Yu
TI  - Myopathy in a 61-year-old Hispanic man
AID  - 10.1136/bcr-2018-228892
DP  - 2019 Apr 01
TA  - BMJ Case Reports
PG  - e228892
VI  - 12
IP  - 4
4099  - http://casereports.bmj.com/content/12/4/e228892.short
4100  - http://casereports.bmj.com/content/12/4/e228892.full
SO  - BMJ Case Reports2019 Apr 01; 12
AB  - A 61-year-old Hispanic man presented to a county hospital for subacute progressive weakness, heliotrope rash and dysphagia. There was initial suspicion for dermatomyositis (DM) given the history; however, the physical exam was not consistent. An MRI followed by a muscle biopsy revealed necrotising autoimmune myositis and anti-3-hydroxy-3-methylglutary-coenzyme A-reductase antibody titers returned positive; the patient was diagnosed with necrotising autoimmune myositis. He was treated with corticosteroids and intravenous immunoglobulin, which resulted in improvement in his weakness and functional status. This case represents a unique instance in which a cardinal feature of DM, the heliotrope rash, prompted an erroneous initial diagnosis. It highlights the necessity of developing abroad differential diagnosis and subsequent thorough investigation into patients presenting with suspected idiopathic immune-mediated myopathies.