Severe Polymyositis with Concomitant Rhabdomyolysis
- VernacularTitle:Хүнд хэлбэрийн полимиозит болон рабдомиолиз хавсарсан эмнэлзүйн тохиолдол
- Author:
Demchigmaa N
1
;
2
;
3
;
Enkhjargal M
2
;
Ganbayar G
2
;
Saymaa L
4
;
Erdenechimeg Ch
5
;
Anu G
2
;
3
;
Namuuntuul D
2
;
3
;
Tsolmon D
1
;
2
;
Devshil Z
1
;
2
;
3
Author Information
1. Department of Rheumatology, School of Medicine, MNUMS
2. Inpatient Department, Mongolia-Japan Hospital, MNUMS
3. Rheumatology Center, Mongolia-Japan Hospital, MNUMS
4. Department of Pathology and Forensic Medicine, School of Biomedicin, MNUMS
5. Outpatient department, National dermatology center
- Publication Type:Case Reports
- Keywords:
Polymyositis;
Rhabdomyolysis;
Myopathy;
Muscle weakness;
Creatine kinase;
Myoglobinuria;
Muscle biopsy
- From:
Mongolian Journal of Health Sciences
2026;96(6):262-266
- CountryMongolia
- Language:Mongolian
-
Abstract:
Background:Polymyositis (PM) is a rare idiopathic inflammatory myopathy characterized by symmetric proximal muscle weakness, elevated muscle enzyme levels, dysphagia, and respiratory muscle weakness. Rhabdomyolysis is a potentially life-threatening condition caused by extensive skeletal muscle breakdown, resulting in myoglobinuria and an increased risk of acute kidney injury and multiorgan complications. The coexistence of rhabdomyolysis in patients with polymyositis is uncommon and may complicate both diagnosis and management.
Case Presentation:A 65-year-old man was admitted with fever up to 39°C, generalized skin rash, dysphagia, progressive muscle weakness, dyspnea, decreased urine output, and dark tea-colored urine. Physical examination revealed symmetric proximal muscle weakness, with muscle strength graded 3/5 in both upper extremities and 4/5 in both lower extremities. Neck muscle strength was 4/5. Dysphagia and a generalized skin rash were also present. Laboratory investigations showed markedly elevated creatine kinase (CK) at 9,943.1 U/L, alanine aminotransferase (ALT) at 449.1 U/L, aspartate aminotransferase (AST) at 222.1 U/L, lactate dehydrogenase (LDH) at 1,342.9 U/L, and C-reactive protein (CRP) at 70.6 mg/L. Urinalysis showed blood 3+ and protein 2+, while no erythrocytes were detected on urine sediment microscopy. Electromyography demonstrated myopathic changes, and muscle biopsy revealed inflammatory infiltrates and necrotic muscle fibers.
Conclusion:Comprehensive assessment of clinical manifestations, laboratory findings, autoantibody testing, electrophysiological studies, and muscle biopsy is essential for the diagnosis of polymyositis complicated by rhabdomyolysis. An integrated diagnostic approach facilitates confirmation of the diagnosis, differentiation from clinically similar disorders, and appropriate treatment selection. Early recognition of rhabdomyolysis and other potentially life-threatening complications is crucial for preventing organ damage and improving patient outcomes.
- Full text:202609270106356631846_Хүнд хэлбэрийн полимиозит болон рабдомиолиз хавсарсан эмнэлзүйн тохиолдол.pdf
