Rheumatoid Myositis: A Rare Case Report
Published: August 1, 2023 | DOI: https://doi.org/10.7860/JCDR/2023/63175.18275
Satish Kumar, Santosh Kumar Singh, Yashas Saipangallu
1. Medical Specialist, Department of Internal Medicine, Armed Forces Medical College, Pune, Maharashtra, India.
2. Professor, Department of Internal Medicine, Armed Forces Medical College, Pune, Maharashtra, India.
3. Resident, Department of Internal Medicine, Armed Forces Medical College, Pune, Maharashtra, India.
Correspondence
Dr. Yashas Saipangallu,
Resident, Department of Internal Medicine, Armed Forces Medical College, Pune-411040, Maharashtra, India.
E-mail: dryashassaipangallu@gmail.com
Rheumatoid Arthritis (RA) and inflammatory myositis are distinct clinical syndromes. Muscle involvement in RA is frequently secondary to therapy with steroids or immune-modulators medication. However, the association of myositis in a treatment- naive patient with RA is rare. Myositis represents a distinct entity with specific clinical, biological, imaging, and histological patterns. Here, authors describe a case of RA presented with myositis. A 30-year-old female presented with insidious onset gradually progressive to paraparesis lasting for six months. This was preceded by a history of inflammatory arthritis involving small and large joints of the upper and lower extremities. Clinically, she exhibited pure motor weakness of the upper and lower limbs (proximal>distal) with hand, elbow, and knee deformities. Her Anti-Cyclic Citrullinated Peptide antibody (Anti-CCP) and inflammatory markers were elevated. Muscle-specific enzymes were also elevated, along with positive myositis-specific antibodies. Electromyography (EMG) and Magnetic Resonance Imaging (MRI) of the thigh revealed findings consistent with inflammatory myositis. The patient was managed as a case of Rheumatoid Myositis (RM) with steroids, conventional, and biological immune-modulators Disease-Modifying Antirheumatic Drugs (DMARDs). She experienced remarkable improvement in her symptoms and quality of life.
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