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Neto Silva I, Kharat A, Marzano F, Marchi E, Duarte JA, Bendjelid K. Unsuccessful Weaning From Mechanical Ventilation in a Patient With An Immune-Mediated Necrotizing Myopathy: A Case Report That Demonstrates the Usefulness of Shear-Wave Elastography. Chest 2024; 165:e177-e185. [PMID: 38852975 PMCID: PMC11177100 DOI: 10.1016/j.chest.2024.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 06/23/2023] [Accepted: 01/02/2024] [Indexed: 06/11/2024] Open
Affiliation(s)
- Ivo Neto Silva
- Department of Acute Medicine, Intensive Care Division, Geneva University Hospitals, Geneva, Switzerland; Care Directorate, Geneva University Hospitals, Geneva, Switzerland; Geneva Hemodynamic Research Group, Faculty of Medicine, University of Geneva, Geneva, Switzerland; Centre of Physical Activity, Health and Leisure (CIAFEL), Faculty of Sport, University of Porto, Porto, Portugal.
| | - Aileen Kharat
- Medicine Department, Division of Respiratory Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Florian Marzano
- Department of Acute Medicine, Intensive Care Division, Geneva University Hospitals, Geneva, Switzerland
| | - Elisa Marchi
- Department of Acute Medicine, Intensive Care Division, Geneva University Hospitals, Geneva, Switzerland
| | - José Alberto Duarte
- Centre of Physical Activity, Health and Leisure (CIAFEL), Faculty of Sport, University of Porto, Porto, Portugal; TOXRUN-Toxicology Research Unit, University Institute of Health Sciences-CESPU, Gandra, Portugal
| | - Karim Bendjelid
- Department of Acute Medicine, Intensive Care Division, Geneva University Hospitals, Geneva, Switzerland; Geneva Hemodynamic Research Group, Faculty of Medicine, University of Geneva, Geneva, Switzerland
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Muruganandam M, Iqbal A, Akpan EB, Dolomisiewicz AC, Waters YM, Emil NS, Nunez SE, McElwee MK, O'Sullivan FX, Fields RA, Sibbitt WL. Statin-associated immune-mediated necrotizing myositis in Native Americans. Rheumatology (Oxford) 2022; 61:4855-4862. [PMID: 35348616 DOI: 10.1093/rheumatology/keac198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 03/16/2022] [Indexed: 01/11/2023] Open
Abstract
OBJECTIVES Statin-associated immune-mediated necrotizing myopathy (IMNM) and idiopathic inflammatory myositis (IIM) are myopathies with overlapping features. This study compared the manifestations of IMNM to IIM in Native Americans. METHOD Twenty-one Native American patients with inflammatory myopathy (IM) were characterized as to diabetes mellitus, hyperlipidaemia, statin exposure, myopathy diagnosis, muscle histology, autoimmune and myositis-specific autoantibodies, therapy and outcome. RESULTS IM consisted of 52.4% IMNM, 42.9% IIM and 4.8% metabolic myopathy. IMNM vs IIM patients were older [61.6 years (s.d. 9.8) vs 39.8 (14.3)], diabetes mellitus (100% vs 55.6%), hyperlipidaemia (100% vs 33.3%), statin-exposure (100% vs 22.2%), creatine kinase [CK; 11 780 IU (s.d. 7064) vs 1707 (1658)], anti-3-hydroxy-3-methylglutaryl coenzyme A reductase (HMGCR) antibodies (85.7% vs 11.1%) and necrotizing IM (81.8% vs 11.1%), but shorter disease duration [26.2 months (s.d. 395) vs 78.4 (47.9)], RP (9.1% vs 55.6%), cutaneous manifestations (0% vs 55.6%), ANA (18.2% vs 66.7%) or any autoantibody (18.2% vs 88.9%) (all P < 0.05). MRI abnormalities, histologic IM, myositis-specific autoantibodies, pulmonary hypertension, oesophageal dysfunction, interstitial lung disease, disability and persistently elevated CK were similar. IMNM vs IIM was treated more with IVIG (72.7% vs 11.1%; P = 0.009) and less with antimetabolites (45.5% vs 88.9%; P = 0.05) and rituximab (18.2% vs 55.6%; P = 0.09). CONCLUSIONS IMNM may occur in Native Americans and is associated with diabetes mellitus, hyperlipidaemia, statin use and older age and is characterized by marked CK elevation, necrotizing myopathy and anti-HMGCR antibodies with few cutaneous or vascular manifestations.
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Affiliation(s)
- Maheswari Muruganandam
- Department of Internal Medicine, Division of Rheumatology and School of Medicine, University of New Mexico Health Sciences Center, Albuquerque, NM
| | - Ahsan Iqbal
- Department of Internal Medicine, Division of Rheumatology and School of Medicine, University of New Mexico Health Sciences Center, Albuquerque, NM
| | - Eyerusalem B Akpan
- Department of Internal Medicine, Division of Rheumatology and School of Medicine, University of New Mexico Health Sciences Center, Albuquerque, NM
| | - Anthony C Dolomisiewicz
- Department of Internal Medicine, Division of Rheumatology and Immunology, University of Nebraska Medical Center, Nebraska Medical Center, Omaha, NE, USA
| | - Yvonne M Waters
- Department of Internal Medicine, Division of Rheumatology and School of Medicine, University of New Mexico Health Sciences Center, Albuquerque, NM
| | - N Suzanne Emil
- Department of Internal Medicine, Division of Rheumatology and School of Medicine, University of New Mexico Health Sciences Center, Albuquerque, NM
| | - Sharon E Nunez
- Department of Internal Medicine, Division of Rheumatology and School of Medicine, University of New Mexico Health Sciences Center, Albuquerque, NM
| | - Matthew K McElwee
- Department of Internal Medicine, Division of Rheumatology and School of Medicine, University of New Mexico Health Sciences Center, Albuquerque, NM
| | - Frank X O'Sullivan
- Department of Internal Medicine, Division of Rheumatology and School of Medicine, University of New Mexico Health Sciences Center, Albuquerque, NM
| | - Roderick A Fields
- Department of Internal Medicine, Division of Rheumatology and School of Medicine, University of New Mexico Health Sciences Center, Albuquerque, NM
| | - Wilmer L Sibbitt
- Department of Internal Medicine, Division of Rheumatology and School of Medicine, University of New Mexico Health Sciences Center, Albuquerque, NM
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