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A rare association of early-onset inclusion body myositis, rheumatoid arthritis and autoimmune thyroiditis: a case report and literature review.
[inclusion body myositis]
Sporadic
inclusion
body
myositis
(
sIBM
)
is
a
slowly
progressive
,
red
-rimmed
vacuolar
myopathy
leading
to
muscular
atrophy
and
progressive
weakness
;
it
predominantly
affects
males
older
than
fifty
years
,
and
is
resistant
to
immunotherapy
.
It
has
been
described
in
association
with
immuno-mediated
thrombocytopenic
purpura
,
multiple
sclerosis
,
connective
tissue
disorders
and
,
occasionally
,
rheumatoid
arthritis
.
A
37
-
year
-old
man
with
longstanding
rheumatoid
arthritis
and
autoimmune
thyroiditis
with
hypothyroidism
was
referred
to
us
with
slowly
progressive
,
diffuse
muscle
weakness
and
wasting
,
which
had
initially
involved
the
volar
finger
flexors
,
and
subsequently
also
the
ankle
dorsiflexors
and
knee
extensors
.
Needle
electromyography
showed
typical
myopathic
motor
unit
potentials
,
fibrillation
and
positive
sharp
waves
with
normal
nerve
conduction
studies
.
Quadriceps
muscle
biopsy
was
suggestive
of
sIBM
.
Considering
data
published
in
the
literature
,
this
case
may
be
classified
as
an
early
-onset
form
.
The
patient
was
treated
with
long
-term
intravenous
immunoglobulin
and
obtained
a
substantial
stabilization
of
his
muscle
strength
.
Diseases
Validation
Diseases presenting
"red-rimmed vacuolar myopathy"
symptom
inclusion body myositis
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