C1-inhibitor Deficiency Induces Myositis-like Symptoms Via the Deposition of the Membrane Attack Complex in the Muscle

  • Beck Goichi
    Department of Neurology, Osaka University Graduate School of Medicine, Japan
  • Yamashita Rika
    Department of Neurology, Osaka University Graduate School of Medicine, Japan
  • Saeki Chizu
    Department of Neurology, Osaka University Graduate School of Medicine, Japan
  • Ogawa Takuya
    Department of Neurology, Osaka University Graduate School of Medicine, Japan
  • Shimizu Mikito
    Department of Neurology, Osaka University Graduate School of Medicine, Japan
  • Mochizuki Hideki
    Department of Neurology, Osaka University Graduate School of Medicine, Japan

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Abstract

<p>We herein report a 56-year-old Japanese woman who had been diagnosed with hereditary angioedema. She experienced progressing muscle weakness and pain in the upper and lower extremities. Blood tests revealed a marked increase in creatine kinase levels; however, myositis-specific autoantibodies were not detected. Serum C1-inhibitor activity and C4 levels were low. A muscle biopsy showed mild muscle fiber necrosis and C5b-9 deposition in the endomysial capillary vessel walls and sarcolemma, mimicking necrotizing myopathy. These results suggest that C1-inhibitor deficiency induces myositis-like symptoms through the activation of the complement pathway and deposition of the membrane attack complex in the muscles. </p>

Journal

  • Internal Medicine

    Internal Medicine 59 (17), 2173-2176, 2020-09-01

    The Japanese Society of Internal Medicine

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