RT Journal Article
SR Electronic
T1 Myopathy in a 61-year-old Hispanic man
JF BMJ Case Reports
JO BMJ Case Reports
FD BMJ Publishing Group Ltd
SP e228892
DO 10.1136/bcr-2018-228892
VO 12
IS 4
A1 Parizher, Gary
A1 Brown, Timothy J
A1 Hon, Mary
A1 Joerns, Elena K
A1 Zuo, Yu
YR 2019
UL http://casereports.bmj.com/content/12/4/e228892.abstract
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.