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Immune-Mediated Necrotizing Myopathy Initially Presenting as Erythema Nodosum

Authors Ying S, Li S, Tang S, Sun Q, Fang D, Li Y, Zhu D, Fang H, Qiao J

Received 17 July 2020

Accepted for publication 11 August 2020

Published 24 August 2020 Volume 2020:13 Pages 471—476


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Professor Ning Quan

Shuni Ying, Sheng Li, Shunli Tang, Qingmiao Sun, Deren Fang, Yali Li, Dingxian Zhu, Hong Fang, Jianjun Qiao

Department of Dermatology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, People’s Republic of China

Correspondence: Jianjun Qiao; Hong Fang
Department of Dermatology, The First Affiliated Hospital, Zhejiang University School of Medicine, No. 79, Qingchun Road, Hangzhou 310003, People’s Republic of China
Tel +86-571-87236385

Abstract: Immune-mediated necrotizing myopathy (IMNM) is a type of autoimmune myopathy characterized by severe diffuse proximal myofiber necrosis in the context of inflammatory myopathy. Autoantibodies of anti-signal recognition particle and anti-hydroxy-3-methylglutaryl-CoA reductase are two antibodies specific to IMNM. Erythema nodosum (EN) is often accompanied by various systemic diseases, such as autoimmune diseases. Herein, we report a female patient with signal recognition particle-associated IMNM, with EN as the first presentation. She showed significant clinical improvement after the initiation of glucocorticoids, intravenous immunoglobulin, rituximab, and mycophenolate mofetil. This case indicates that IMNM can initially present as EN. IMNM and EN might have overlapping pathogeneses.

Keywords: immune-mediated necrotizing myopathy, erythema nodosum, autoantibody

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