Background It is well known that myalgia occurs in 40% to 80% of patients with systemic lupus erythematosus (SLE). However, the clinical charasteristics of muscular symptoms associated SLE has not been studied enough.
Objectives The aim of this study is to analyze the clinical characteristics of muscular symptoms associated SLE.
Methods We retrospectively reviewed the medical record of SLE patient who presented muscular symptoms (muscle weakness or myalgia) between January 2010 and December 2012. We identified 7 SLE patients who developed muscular symptoms. The clinical characteristics, muscle enzymes, laboratory data, MRI fingings, and pathological findings were analyzed.
Results At the time of muscle symptom onset, the mean patient age was 32.7±11.1 years, with a male-female ratio of 1:6. All cases showed low complement levels, and showed elevated levels of ds-DNA antibodies. The mean SLE Disease Activity Index (SLEDAI) was 16±6.22. Serum creatine kinase was elevated in 1 of the 7 cases. Meanwhile, all cases showed increased aldolase and the STIR MRI of the muscles revealed a high intensity signal showing myofascial dominance over muscle. Moreover, en bloc biopsy was performed in 4 cases and like the MRI findings, myofascial-dominant mononuclear cell infiltrates were observed. In all cases, a moderate to high dose of prednisolone was administered and muscle symptoms improved. This was accompanied by an improvement in muscle symptoms, decreases in aldolase, ds-DNA antibodies and SLEDAI, and an increase in complement levels.
Conclusions In SLE patients with muscular symptoms, fasciitis was demonstrated by MRI or pathological findings. Fasciitis may contribute to muscular symptoms in patients with SLE.
Tsokos GC, Moutsopoulos HM, Steinberg AD. Muscle involvement in systemic lupus erythematosus. JAMA 1981;246:766-8.
Disclosure of Interest None declared