Open AccessDYSPHAGIA SECONDARY TO ANTI-HMGCR AUTOIMMUNE NECROTIZING MYOPATHY
Author(s) -
Eduardo Valdivielso Cortázar,
Manuel Delgado Blanco,
Pedro Aguirre
Publication year - 2020
Publication title -
revista española de enfermedades digestivas/revista española de enfermedades digestivas
Language(s) - Uncategorized
Resource type - Journals
SCImago Journal Rank - 0.331
H-Index - 38
eISSN - 2340-4167
pISSN - 1130-0108
DOI - 10.17235/reed.2020.7324/2020
Subject(s) - medicine , dysphagia , hiatal hernia , muscle biopsy , myopathy , gastroenterology , weakness , aspiration pneumonia , biopsy , reflux , surgery , pneumonia , disease
We present the case of an 87-year-old female who presented with upper dysphagia to solids, weight loss of 5 kg and weakness in the upper limbs of a seven months duration. Gastroscopy showed a hiatal hernia and an esophagogram showed gastroesophageal reflux and contrast aspiration into the trachea. Esophageal manometry was not possible due to intolerance. Analytics showed elevated CPK (3,386 UI/l; 34-145) and positivity to anti-HMGCR antibodies. An electromyogram was performed, with more intense myopathy data in the proximal regions of the upper limbs and signs of myositis. A muscle biopsy was performed (deltoids and biceps) that showed signs of necrotizing myopathy. Treatment with oral steroids and methotrexate was started with a good subsequent evolution.