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Immune-mediated necrotizing myopathy
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Immune-mediated necrotizing myopathy

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Contributors: Benjamin L. Mazer MD, MBA
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Synopsis

Immune-mediated necrotizing myopathy (IMNP) is a recently described, very rare inflammatory myopathy in the same category as dermatomyositis and polymyositis. Like those diseases, it presents with proximal muscle weakness and elevated muscle enzymes. IMNP is caused by autoantibodies that recognize "anti-signal recognition particle." A small number of cases are attributed to statin use producing antibodies to HMG-CoA reductase.

Muscle biopsy shows muscle fiber necrosis without inflammatory cells.

Immunosuppressive medications, including corticosteroids, intravenous immunoglobulin (IVIg), and rituximab, are used to treat the disease. Statins should be discontinued in cases associated with these drugs.

Codes

ICD10CM:
G72.49 – Other inflammatory and immune myopathies, not elsewhere classified

SNOMEDCT:
128496001 – Inflammatory disorder of muscle

Diagnostic Pearls

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Differential Diagnosis & Pitfalls

Best Tests

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Drug Reaction Data

Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.

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References

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Last Updated: 05/27/2016
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Immune-mediated necrotizing myopathy
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Immune-mediated necrotizing myopathy : Proximal muscle weakness, Symmetric extremities, HMG-CoA reductase inhibitor, Dyspnea, CPK elevated
Copyright © 2018 VisualDx®. All rights reserved.