Year 2021 / Volume 113 / Number 10
Letter
Dysphagia secondary to autoimmune necrotizing anti-HGMCR myopathy

729-730

DOI: 10.17235/reed.2020.7324/2020

Eduardo Valdivielso Cortázar, Manuel Delgado Blanco, Pedro Alonso Aguirre,

Abstract
We present the case of an 87-year-old female who presented with upper dysphagia to solids, weight loss of 5 kg and weakness in the upper limbs of a seven months duration. Gastroscopy showed a hiatal hernia and an esophagogram showed gastroesophageal reflux and contrast aspiration into the trachea. Esophageal manometry was not possible due to intolerance. Analytics showed elevated CPK (3,386 UI/l; 34-145) and positivity to anti-HMGCR antibodies. An electromyogram was performed, with more intense myopathy data in the proximal regions of the upper limbs and signs of myositis. A muscle biopsy was performed (deltoids and biceps) that showed signs of necrotizing myopathy. Treatment with oral steroids and methotrexate was started with a good subsequent evolution.
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References
1. Pinal-Fernández I, Casal Domínguez M, Mammen AL. Inmune-Mediated Necrotizing Myopathy. Curr Rheumatol Rep 2018;26:21 doi: 10.1007/s11926-018-0732-6
2. Casal-Dominguez M, Pinal-Fernández I, Mego M et al. High Resolution Manometry in patients with Idiophatic Inflammatory Myopathy: Elevated Prevalence of Esophageal Involvement and differences according to autoantibody status and clinical subset. Muscle Nerve 2017;56:386-92
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4. Mohassel P, Mammen AL. Anti-HMGCR Myopathy. J Neuromuscul Dis 2018;5:11-20
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Valdivielso Cortázar E, Delgado Blanco M, Alonso Aguirre P. Dysphagia secondary to autoimmune necrotizing anti-HGMCR myopathy. 7324/2020


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Publication history

Received: 08/06/2020

Accepted: 13/06/2020

Online First: 23/11/2020

Published: 06/10/2021

Article revision time: 4 days

Article Online First time: 168 days

Article editing time: 485 days


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