Isolated Oropharyngeal Dysphagia as the Initial Presentation of Anti-SRP Immune-Mediated Necrotizing Myopathy

Pat Korathanakhun, Thanyalak Amornpojnimman

Abstract

A 51-year-old male initially presented with a progressive course of isolated oropharyngeal dysphagia prior to the clinical course of painful symmetrical proximal muscle weakness without sensory deficit which rendered him to wheelchairbound status within 5 months. The physical examination revealed symmetrical proximal muscle weakness without sensory symptoms. The initial serum creatine kinase was extremely high and the electrodiagnostic study revealed a myopathic pattern. A muscle biopsy of the left biceps suggested a diagnosis of immune-mediated necrotizing myopathy (IMNM) and the serum anti-signal recognition particle (SRP) autoantibody was finally detected. This case presented a rare form of anti-SRP IMNM in which isolated oropharyngeal dysphagia preceded the onset of proximal muscle weakness.

 Keywords

anti-SRP autoantibody; immune-mediated necrotizing myopathy; oropharyngeal dysphagia

 Full Text:

PDF

References

Watanabe Y, Uruha A, Suzuki S, Nakahara J, Hamanaka K, Takayama K, et al. Clinical features and prognosis in antiSRP and anti-HMGCR necrotizing myopathy. J Neuro Neurosurg Psychiatry 2016;87:1038-44.

Suzuki S, Nishikawa A, Kuwana M, Nishimura H, Watanabe Y, Nakahara J, et al. Inflammatory myopathy with anti-signal recognition particle antibodies: case series of 100 patients. Orphanet J Rare Dis 2015;10:61.

Casciola-Rosen L, Mammen AL. Myositis autoantibodies. Curr Opin Rheumatol 2012;24:602-8.

Jaradeh S. Muscle disorders affecting oral and pharyngeal swallowing. GI motility online [homepage on the Internet]. 2006 [cited 2020 May 18]. Available from: https://www.nature. com/gimo/contents/pt1/full/gimo35.html

Ebert EC. Review article: the gastrointestinal complications of myositis. Alimen Phamacol Ther 2010;31:359-65.

Oh TH, Brumfield KA, Hoskin TL, Stolp KA, Murray JA, Bassford JR. Dysphagia in inflammatory myopathy: clinical characteristics, treatment strategies, and outcome in 62 patients. Mayo Clin Proc 2007;82:441-7.

Allenbach Y, Mammen AL, Benveniste O, Stenzel W. 224th ENMC International Workshop: clinico-sero-pathological classification of immune-mediated necrotizing myopathies Zandvoort, The Netherlands, 14-16 October 2016. Neuromuscul Disord 2018;28:87-99.

Allenbach Y, Karaen J, Bouvier A, Jooste V, Champtiaux N, Hervier B, et al. High risk of cancer in autoimmune necrotizing myopathies: usefulness of myositis specific antibody. Brain 2016;139:2131-5.

Mugii N, Hasegawa M, Matsuchita T, Hamaguchi Y, Oohata S, Okita H, et al. Oropharyngeal dysphagia in dermatomyositis: associations with clinical and laboratory features including autoantibodies. Plos One 2016;10:1371.

DOI: http://dx.doi.org/10.31584/jhsmr.2020760

Refbacks

  • There are currently no refbacks.
Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.