The second patient initially presented with severe respiratory muscle weakness leading to hypoxic hypercapnic respiratory failure and cardiac involvement. Therefore, we gave him a combination of IVIG and high-dose steroids, and he responded well.
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Explore This IssueDecember 2017
HMGCR Ab-related IMNM can present with severe respiratory muscle weakness that leads to hypoxic hypercapnic respiratory failure, dysphagia and cardiac involvement, which can contribute to significant morbidity and mortality. Persistently high CPK levels, progressive muscle weakness, dysphagia and respiratory muscle involvement include some of the indicators of severe disease. Doctors must promptly identify such patients and manage them with aggressive immunosuppression.
Shivani Garg, MD, is an assistant professor in the Department of Internal Medicine, Division of Rheumatology at the School of Medicine and Public Health in the University of Wisconsin in Madison, Wis.
Suzana Alex John, MD, is a fellow in the Department of Rheumatology at Emory University in Atlanta.
Frehiywot Ayele, MD, is an assistant professor in the Department of Rheumatology at Emory University in Atlanta.
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