| Citation: |
LIANG Chunsu, ZHANG Xuchang, ZHANG Ning, KANG Lin, LIU Xiaohong, YU Jiaqi, LIU Yingxian, QIAO Lin, YANG Yanli, ZHAO Xiaoyi, ZHAO Ruijie, NIU Na, YAN Xuelian. Palpitations, Shortness of Breath, Weakness in Limbs, Edema, and Dyspnea: A Rare Inflammatory Myopathy with Positive Aniti-mitochondrial Antibodies and Cardiac Involvement[J]. Medical Journal of Peking Union Medical College Hospital, 2025, 16(1): 248-255. DOI: 10.12290/xhyxzz.2024-0078
|
This article presents a case study of a patient who visited the Geriatric Department of Peking Union Medical College Hospital due to "palpitations, shortness of breath for more than 2 years, limb weakness for 6 months, edema, and nocturnal dyspnea for 2 months". The patient exhibited decreased muscle strength in the limbs and involvement of swallowing and respiratory muscles, alongside complications of heart failure and various arrhythmias which were predominantly atrial. Laboratory tests revealed the presence of multiple autoantibodies and notably anti-mitochondrial antibodies. Following a comprehensive multidisciplinary evaluation, the patient was diagnosed with anti-mitochondrial antibody-associated inflammatory myopathy. Treatment involved a combination of glucocorticoids and immunosuppressants, along with resistance exercises for muscle strength and rehabilitation training for lung function, resulting in significant improvement of clinical symptoms. The case underscores the importance of collaborative multidisciplinary approaches in diagnosing and treating rare diseases in elderly patients, where careful consideration of clinical manifestations and subtle abnormal clinical data can lead to effective interventions.
| [1] |
Malaviya A N. 2017 EULAR/ACR classification criteria for adult and juvenile idiopathic inflammatory myopathies and their major subgroups: little emphasis on autoantibodies, why?[J]. Ann Rheum Dis, 2018, 77(11): e77. DOI: 10.1136/annrheumdis-2017-212701
|
| [2] |
Zhang L, Wang G C, Ma L, et al. Cardiac involvement in adult polymyositis or dermatomyositis: a systematic review[J]. Clin Cardiol, 2012, 35(11): 686-691. http://www.xueshufan.com/publication/2056425966
|
| [3] |
Liu Y X, Hsu J, Liu X H, et al. Electrophysiological, structural, and functional disorders in patients with inflammatory cardiomyopathy secondary to inflammatory myopathy[J]. Ann Noninvasive Electrocardiol, 2022, 27(4): e12938. DOI: 10.1111/anec.12938
|
| [4] |
Huang Y F, Liu H Z, Wu C Y, et al. Ventricular arrhythmia predicts poor outcome in polymyositis/dermatomyositis with myocardial involvement[J]. Rheumatology (Oxford), 2021, 60(8): 3809-3816. DOI: 10.1093/rheumatology/keaa872
|
| [5] |
Zhang L X, Zhu H Y, Yang P T, et al. Myocardial involvement in idiopathic inflammatory myopathies: a multi-center cross-sectional study in the CRDC-MYO registry[J]. Clin Rheumatol, 2021, 40(11): 4597-4608. DOI: 10.1007/s10067-021-05828-y
|
| [6] |
Albayda J, Khan A, Casciola-Rosen L, et al. Inflammatory myopathy associated with anti-mitochondrial antibodies: a distinct phenotype with cardiac involvement[J]. Semin Arthritis Rheum, 2018, 47(4): 552-556. DOI: 10.1016/j.semarthrit.2017.06.004
|
| [7] |
Sabbagh S E, Pinal-Fernandez I, Casal-Dominguez M, et al. Anti-mitochondrial autoantibodies are associated with cardiomyopathy, dysphagia, and features of more severe disease in adult-onset myositis[J]. Clin Rheumatol, 2021, 40(10): 4095-4100. DOI: 10.1007/s10067-021-05730-7
|
| [8] |
Liu Y X, Fang L G, Chen W, et al. Identification of characteristics of overt myocarditis in adult patients with idiopathic inflammatory myopathies[J]. Cardiovasc Diagn Ther, 2020, 10(3): 405-420. DOI: 10.21037/cdt.2020.03.04
|
| [9] |
Fairley J L, Wicks I, Peters S, et al. Defining cardiac involvement in idiopathic inflammatory myopathies: a systematic review[J]. Rheumatology (Oxford), 2021, 61(1): 103-120. DOI: 10.1093/rheumatology/keab573
|
| [10] |
Khoo T, Stokes M B, Teo K, et al. Cardiac involvement in idiopathic inflammatory myopathies detected by cardiac magnetic resonance imaging[J]. Clin Rheumatol, 2019, 38(12): 3471-3476. DOI: 10.1007/s10067-019-04678-z
|
| [11] |
路菲, 张宁, 康琳, 等. 肌力下降、呼吸衰竭、心力衰竭、抗线粒体抗体阳性: 罕见炎性肌病的不典型表现[J]. 协和医学杂志, 2022, 13(1): 138-146. DOI: 10.12290/xhyxzz.2020-0109
Lu F, Zhang N, Kang L, et al. Decreased muscle strength, type 2 respiratory failure, heart failure, positive anti-mitochondrial antibodies-rare atypical manifestations of inflammatory myopathy[J]. Med J PUMCH, 2022, 13(1): 138-146. DOI: 10.12290/xhyxzz.2020-0109
|
| [12] |
Wang H, Li H, Kai C, Deng J. Polymyositis associated with hypothyroidism or hyperthyroidism: two cases and review of the literature[J]. Clin Rheumatol, 2011, 30(4): 449-458. DOI: 10.1007/s10067-010-1570-8
|
| [13] |
刘晓红, 康琳. 老年医学诊疗常规[M]. 北京: 中国医药科技出版社, 2017: 91-97.
Liu X H, Kang L. Routine diagnosis and treatment of geriatric medicine[M]. Beijing: China Medical Science Press, 2017: 91-97.
|
Supported by: Beijing Renhe Information Technology Co., Ltd. 
Submit
Review
Office
Email Alert
RSS
DownLoad: