Necrotizing autoimmune myopathy (NAM) is a relatively recently discovered subgroup of inflammatory myopathies. NAM is characterized by predominant muscle fiber necrosis and regeneration with little or no inflammation.1 One subgroup of NAM is 3-hydroxy-3-methylglutaryl-CoA reductase antibody (HMGCR Ab)-related immune-mediated necrotizing myopathy (IMNM), which occurs (rarely) after statin exposure, with a rough incidence of two per…
Ethics Forum: Patient Test Requests Pose Challenges for Rheumatologists
Ethical challenges physicians face when patients request potentially unnecessary medical tests
The Mystery of IVIg
Although initially given as replacement therapy for patients with primary and secondary immunodeficiency states, intravenous immunoglobulin (IVIg) has proven to be effective in the treatment of various autoimmune and inflammatory disorders. This success has led to a dramatic increase in the use of IVIg, with its use as an antiinflammatory agent now vastly surpassing its use in the treatment of immunodeficiencies. Even so, the basis for the antiinflammatory activity of IVIg remains unclear.
Diagnosis: Myopathy
Presentation and evaluation of metabolic causes
Coding Corner Answer: June 2008
June’s Coding Answer