Inflammatory myositis complicating hypocomplementemic urticarial vasculitis despite on-going immunosuppression.
We present a patient with previously diagnosed hypocomplementemic urticarial vasculitis syndrome, with skin, lung, and renal involvement, who presented with congestive cardiac failure. During the course of her hospitalization, she was also found to have profound proximal muscle weakness in both upper and lower limbs associated with raised creatinine kinase levels. A muscle biopsy was performed, which demonstrated evidence of an inflammatory myositis with vasculitis, which had returned despite on-going immunosuppression. This occurrence of a new autoimmune disease may well be an example of the "waste disposal" hypothesis.
Chew
Gary Y J
GY
Department of Immunology, The Canberra Hospital, Woden, Australian Capital Territory, and Australian National University Medical School, Canberra, Australia. gary.chew2@act.gov.au
Gatenby
Paul A
PA
D018501:Antirheumatic Agents / Q000627:therapeutic use; D015922:Complement C1q / Q000172:deficiency* / Q000187:drug effects; D005260:Female; D006801:Humans; D007154:Immune System Diseases / Q000150:complications*; D008727:Methotrexate / Q000627:therapeutic use; D008875:Middle Aged; D009220:Myositis / Q000150:complications* / Q000188:drug therapy / Q000276:immunology; D013577:Syndrome; D014581:Urticaria / Q000150:complications* / Q000188:drug therapy / Q000276:immunology; D014657:Vasculitis / Q000150:complications* / Q000188:drug therapy / Q000276:immunology
D018501:Antirheumatic Agents; D015922:Complement C1q; D008727:Methotrexate