Myositis with antimitochondrial antibodies diagnosed by rectus abdominis muscle biopsy

Uenaka, Takeshi; Kowa, Hisatomo; Sekiguchi, Kenji; Nagata, K.; Ohtsuka, Yukio; Kanda, Fumio; Toda, Tatsushi

doi:10.1002/mus.23730

Cited by 16 publications

(14 citation statements)

References 5 publications

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“…c Representative images in skeletal muscle CT were shown. In the patient with anti-M2 antibody (upper panel) [11], paravertebral muscle was severely atrophied, although quadriceps was nearly intact. In the patient without anti-M2 (lower panel), Mm.…”

Section: Resultsmentioning

confidence: 99%

“…Inflammation appeared to be more intense in the trunk, rather than in the limbs of the positive group. We previously reported a case of anti-M2 antibody-positive myositis that was un-diagnosed following the initial biopsy of the M. biceps brachii , and required the second biopsy of the rectus abdominis muscle [11]. The underlying reasons for the observed reduced intensity in inflammatory changes in the extremities remain unclear.…”

Section: Discussionmentioning

confidence: 99%

“…The cryostat sections of the muscles were processed by staining with hematoxylin-eosin, modified Gomori’s trichrome. We also compared the frequency of lymphocytic infiltration in the skeletal muscle because previous studies reported less inflammation in the biopsied specimens of myositis in the presence of the anti-M2 antibody [4-6, 11]. Lymphocytic infiltration was defined as positive when more than 5 inflammatory cells infiltrated the perivascular or endomysium in the muscle tissues.…”

Section: Methodsmentioning

confidence: 99%

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Less Limb Muscle Involvement in Myositis Patients with Anti-Mitochondrial Antibodies

et al. 2017

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Recent studies have revealed the clinical, histological, and pathophysiological characteristics in a group of inflammatory myopathies with selected autoantibodies. We retrospectively compared the clinical manifestations and histological features between 8 anti-mitochondrial (anti-M2) antibody-positive and 33 antibody-negative patients. Patients with anti-M2 antibodies have been previously reported to have delayed diagnostic confirmation and frequent cardiopulmonary complications in comparison to those without the antibodies. In our study, clinical characteristics in patients with the antibodies were as follows: lesser degree of limb muscle weakness and atrophy as well as lymphocytic infiltration in muscle biopsy specimens, and frequent paravertebral muscle atrophy. Anti-M2 antibody appeared to be a biomarker related to not only cardiopulmonary complications, but also characteristic distributions of affected muscles.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Less Limb Muscle Involvement in Myositis Patients with Anti-Mitochondrial Antibodies

et al. 2017

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“…Indeed, we found that the clinical features in patients with AMAs showed great variability. Firstly, although AMAs only occurred in adult IIM patients, the age at onset ranged from 23 years to 86 years and the mean age at onset ranged from the fourth decade to the seventh decade [3][4][5]7,8,[20][21][22][23][24][25][26] . Besides, the average disease duration varied from 10 months (in our study) to 6.5 years, and the prevalence of chronic disease duration varied from approximately 30% (in our study) to 85% [3,5,6] .…”

Section: Discussionmentioning

confidence: 99%

Idiopathic inflammatory myopathies with anti-mitochondrial antibodies: Clinical features and treatment outcomes in a Chinese cohort

Hou

Liu

Luo

et al. 2019

Neuromuscular Disorders

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Anti-mitochondrial antibodies, the hallmark of primary biliary cirrhosis, have been detected in many patients with idiopathic inflammatory myopathies and these anti-mitochondrial-antibody-associated idiopathic inflammatory myopathies frequently show unique characteristics. We detected anti-mitochondrial antibodies in Chinese idiopathic inflammatory myopathy and summarized the clinical findings of these antimitochondrial-antibody-positive patients. Of 136 patients, seven (5.15%) were found to be anti-mitochondrial-antibody-positive. Primary biliary cirrhosis was present in 2 of these 7 patients, chronic disease duration in 2 patients and asymmetrical muscle weakness in 4 patients. The mean disease course was 8.58 months, and the mean creatine kinase level was 2256.53 U/L. Myositis-specific antibodies were found in 3 patients. According to clinical features and muscle histopathological findings, 3 patients were classified as dermatomyositis, 2 as possible polymyositis and 2 as necrotizing autoimmune myopathy. Of the 6 anti-mitochondrial-antibody-positive patients receiving follow-ups of 12-83 months, they all showed marked clinical improvement. Our study indicates that anti-mitochondrial antibodies are relatively rare in Chinese idiopathic inflammatory myopathy patients. These patients generally show various clinical features and have favorable treatment outcomes. Anti-mitochondrial antibody testing may be helpful to confirm the diagnosis of idiopathic inflammatory myopathy, especially in patients with atypical manifestations.

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“…There have been reports of cases diagnosed as a result of atrial fibrillation and the detection of heart failure symptoms,20 and Maeda et al 12 reported that 2 out of 24 (8%) AMA-positive cases of myositis were first detected with arrhythmia. Our patient was hospitalised as a result of an AFL noted on his ECG findings, and he was subsequently diagnosed following an AMA evaluation performed due to mildly abnormal AST/ALT results noted on hospitalisation.…”

Section: Discussionmentioning

confidence: 99%

Antimitochondrial antibodies-positive myositis accompanied by cardiac involvement

et al. 2017

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We report a 55-year-old man who experienced proximal muscle weakness accompanied by the atrial flutter (AFL) with 1:1 conduction. Detailed examination revealed elevated antimitochondrial antibodies (AMA) and creatine kinase (CK). AFL was converted to sinus rhythm by cardioversion. He was diagnosed as AMA-positive myositis-associated AFL and was treated by prednisolone. Although his muscle weakness and CK level improved, AFL with 1:1 conduction reappeared. Therefore, radiofrequency catheter ablation (RFCA) was needed to treat the AFL, resulting in maintenance of sinus rhythm. This case report describes cardiac involvement in a patient with AMA-positive myositis.

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Myositis with antimitochondrial antibodies diagnosed by rectus abdominis muscle biopsy

Abstract: In myositis patients with antimitochondrial M2 antibodies, muscles of the extremities are involved to a lesser extent. Radiological and histological examination focusing on truncal muscles, including a biopsy, is important.

Cited by 16 publications

References 5 publications

Less Limb Muscle Involvement in Myositis Patients with Anti-Mitochondrial Antibodies

Less Limb Muscle Involvement in Myositis Patients with Anti-Mitochondrial Antibodies

Idiopathic inflammatory myopathies with anti-mitochondrial antibodies: Clinical features and treatment outcomes in a Chinese cohort

Antimitochondrial antibodies-positive myositis accompanied by cardiac involvement

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