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Case Report of an Atypical Presentation of Inclusion Body Myositis Masquerading as Polymyalgia Rheumatica
Pallavi Velagapudi1, Diego Lugo Baruqui1, Ahmed Elghawy2
1Department of Internal Medicine, Mount Sinai Medical Center, Miami Beach, FL, United States.
Current Rheumatology Reviews
|July 1, 2025
Summary
This case highlights the diagnostic challenges of inclusion body myositis (IBM), a rare inflammatory myopathy. Early recognition of its unique symptoms is crucial for accurate diagnosis and management.
Area of Science:
- Rheumatology
- Neurology
- Immunology
Background:
- Idiopathic inflammatory myopathies (IIMs) are rheumatologic conditions characterized by progressive muscle weakness and inflammation.
- Inclusion body myositis (IBM) typically presents insidiously in older men with asymmetric distal weakness.
Observation:
- A 59-year-old man presented with symmetrical proximal muscle weakness and severe pain in shoulders and hips.
- Elevated creatinine phosphokinase (CPK) levels were noted, which are uncharacteristic of typical IBM or polymyalgia rheumatica (PMR).
Findings:
- Despite initial suspicion of PMR, a muscle biopsy confirmed inclusion body myositis.
- The patient's presentation deviated from the classic IBM phenotype, emphasizing diagnostic complexity.
Implications:
- This case highlights the diagnostic challenges posed by IBM's slow progression and overlapping symptoms with other conditions.
- Recognizing atypical presentations of IBM is vital for timely and accurate diagnosis.
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