Dermatomyositis-Induced Rhabdomyolysis With Features of Necrotizing Myopathy and Acute Inflammatory Demyelinating Polyneuropathy in an Epstein-Barr Virus Infected Patient

Ammar Haikal; Swati Govil; Arsany Anis; Jenna Guma

doi:10.7759/cureus.12077

Dermatomyositis-Induced Rhabdomyolysis With Features of Necrotizing Myopathy and Acute Inflammatory Demyelinating Polyneuropathy in an Epstein-Barr Virus Infected Patient

Cureus. 2020 Dec 14;12(12):e12077. doi: 10.7759/cureus.12077.

Authors

Ammar Haikal¹, Swati Govil², Arsany Anis³, Jenna Guma⁴

Affiliations

¹ Internal Medicine, Hackensack Meridian Medical Center, Hackensack, USA.
² Internal Medicine, Hackensack Meridian Health Palisades Medical Center, North Bergen, USA.
³ Internal Medicine, Saint Michael's Medical Center, Newark, USA.
⁴ Internal Medicine, Rowan University School of Osteopathic Medicine, Stratford, USA.

Abstract

Dermatomyositis (DM) is an autoimmune inflammatory myopathy characterized by features of a typical rash, proximal muscle weakness, and evidence of muscle inflammation. Acute inflammatory demyelinating polyneuropathy (AIDP) is an autoimmune peripheral nerve disease characterized by myelin damage and progressive areflexic weakness and sensory changes. AIDP can be precipitated by viral infections such as Epstein-Barr virus (EBV). We present a case of DM with rhabdomyolysis and necrotizing features, along with AIDP in the setting of EBV viremia. DM and AIDP rarely coincide together. The patient was treated with a combination therapy of methylprednisolone, azathioprine, and intravenous immunoglobulins (IVIGs), which led to significant improvement in his symptoms.

Keywords: acute inflammatory demyelinating polyneuropathy; dermatomyositis; elevated creatine phosphokinase (cpk); epstein-barr virus; inflammatory myopathy; necrotizing myopathy.

Publication types

Case Reports