Rare Diseases Symptoms Automatic Extraction

[Necrotizing autoimmune myopathies].

[inclusion body myositis]

Necrotizing autoimmune myopathies are included in the spectrum of inflammatory myopathies, together with polymyosis, dermatopolymyosis and inclusion body myositis, despite the characteristic feature of marked muscular necrosis without inflammatory infiltrates. The clinical presentation is highly variable, often similar to the other inflammatory myopathies. The most common finding is nevertheless the severe form with rhabdomyolysis. The creatine kinase level is elevated (around 10,000IU/l) and electromyography shows myopathic changes with increased spontaneous activities reflecting the importance of the muscular necrosis. Muscle biopsy is required for diagnosis, revealing active necrosis of the muscle fibers without inflammatory invasion by CDA+ or CD8+ T-cells. Deposition of a microvascular membrane attack complex (C5b9) is often noted, whereas the upregulation of MHC class 1 is rarely detected. Signs of endomysial microangiopathy are frequently reported. Necrotizing autoimmune myopathies can be associated with antisignal recognition particle (SRP) antibodies or more rarely with the usual inflammatory myopathy antibodies. Paraneoplasic forms are described but remain exceptional. Lastly, necrotizing autoimmune myopathies, sometimes associated with statin therapy, have been recently described. They are linked with an antibody directed against 3-hydroxy-3-methyglutaryl-coenzyme A. Treatment is based on corticosteroid therapy, immunosuppressive drugs or intravenous immunoglobulins. Response is variable, depending on the clinical form.

Diseases presenting "severe form" symptom

  • alpha-thalassemia
  • benign recurrent intrahepatic cholestasis
  • canavan disease
  • child syndrome
  • congenital adrenal hyperplasia
  • dentinogenesis imperfecta
  • dystrophic epidermolysis bullosa
  • fabry disease
  • familial hypocalciuric hypercalcemia
  • familial mediterranean fever
  • harlequin ichthyosis
  • heparin-induced thrombocytopenia
  • hirschsprung disease
  • inclusion body myositis
  • kindler syndrome
  • lamellar ichthyosis
  • legionellosis
  • locked-in syndrome
  • megacystis-microcolon-intestinal hypoperistalsis syndrome
  • neonatal adrenoleukodystrophy
  • neuralgic amyotrophy
  • papillon-lefèvre syndrome
  • zellweger syndrome

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