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Anti-SRP Myopathy with Sensorimotor Polyneuropathy: A Case Report
Lei-Ying Huang1, Yi-Jen Peng2, Yueh-Feng Sung3
1Department of Anesthesiology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
Acta Neurologica Taiwanica
|September 19, 2023
Summary
Anti-signal recognition particle (SRP) myopathy, a rare immune condition, can affect nerves, causing sensorimotor polyneuropathy. This case highlights the importance of considering peripheral nerve involvement in anti-SRP myopathy.
Area of Science:
- Neurology
- Immunology
- Genetics
Background:
- Anti-signal recognition particle (SRP) myopathy is a rare immune-mediated necrotizing myopathy.
- Extramuscular manifestations are uncommon, but can involve skin, lungs, and heart.
Observation:
- A 33-year-old woman presented with a year of progressive lower limb weakness and numbness.
- Electromyography and nerve conduction studies indicated a combined myopathy and axonal sensorimotor polyneuropathy.
- Elevated serum muscle enzymes and anti-SRP antibodies were detected; MRI showed thigh muscle fatty replacement.
Findings:
- The patient responded to immunosuppressive therapy (methylprednisolone, prednisolone, azathioprine) with improved muscle strength and reduced enzyme levels.
- However, follow-up nerve conduction studies revealed persistent axonal degeneration in the lower limbs two years later.
Implications:
- This case demonstrates that anti-SRP myopathy can manifest with sensorimotor polyneuropathy.
- Clinicians should consider the potential for concurrent skeletal muscle and peripheral nerve pathology in anti-SRP myopathy.
- Early recognition and comprehensive evaluation are crucial for managing this complex autoimmune condition.
