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- Atsuhiko Sugiyama, Yosuke Onishi, Kimiko Ito, Kazumoto Shibuya, Keigo Nakamura, Fumiko Oda, Ichizo Nishino, Shigeaki Suzuki, and Satoshi Kuwabara.
- Department of Neurology, Graduate School of Medicine, Chiba University, Japan.
- Intern. Med. 2021 Aug 15; 60 (16): 2671-2675.
AbstractWe herein report a case of seronegative immune-mediated necrotizing myopathy (IMNM) concurrent with anti-Kv1.4 and anti-titin antibodies. A 72-year-old Japanese woman presented with a 29-year history of fluctuating high serum creatine kinase (CK) levels followed by intermittent ptosis and respiratory muscle weakness. This case highlights the fact that marked respiratory muscle weakness requiring intubation can be seen in an ambulant patient with IMNM. Marked respiratory muscle weakness, rhabdomyolysis-like acute elevation of CK levels, and anti-striational muscle antibodies may be a characteristic constellation of findings in a distinct subgroup of patients with inflammatory myopathy with myasthenia gravis or similar symptoms.
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