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Immune-mediated myositis in Crohn's disease
Takashi Shimoyama1, Yohei Tamura, Tsuyoshi Sakamoto
1Department of Neurology, Jikei University School of Medicine, Tokyo, Japan.
Muscle & Nerve
|December 18, 2008
Summary
This study details a Crohn's disease patient with muscle weakness and elevated creatine kinase. Treating bowel inflammation improved myositis, suggesting an immune-mediated link.
Area of Science:
- Immunology
- Gastroenterology
- Neurology
Background:
- Crohn's disease is a chronic inflammatory bowel disease.
- Muscle weakness and elevated creatine kinase can occur in Crohn's disease patients.
Observation:
- A patient with uncontrolled Crohn's disease presented with progressive proximal muscle weakness and elevated serum creatine kinase.
- Muscle biopsy revealed myositic changes with macrophages (CD68-positive) and T lymphocytes (CD4/CD8-positive).
- The resected colon showed inflammation primarily involving macrophages, mirroring muscle pathology.
Findings:
- Histopathological findings in both muscle and colon were analogous, characterized by macrophage-predominant inflammation.
- Improved muscle symptoms correlated with increased mesalazine dosage and partial colectomy for bowel inflammation.
Implications:
- Myositis in Crohn's disease appears to be immune-mediated.
- Prioritizing treatment of bowel inflammation is crucial, potentially more so than general immunosuppression.
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