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Published online: 2024-05-27

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Myositis with creatinine phosphokinase activity over 13,500 U/L in the course of granulomatosis with polyangiitis

Mikołaj Kamiński1, Paweł Hrycaj1

Abstract

This study presents a detailed account of an exceptional case of severe myositis, characterized by an initial creatine phosphokinase (CPK) level of 13,575 U/L, in a 66-year-old female patient with a seven-year history of granulomatosis with polyangiitis (GPA). The patient’s condition was marked by significant deterioration in overall health, characterized by muscle weakness in the upper and lower extremities that resulted in her becoming bedridden. Treatment with methylprednisolone was initiated, leading to a significant decrease in CPK levels, yet the patient's health saw only minor improvement. The patient did not have autoantibodies usually associated with idiopathic inflammatory myositis. The patient ultimately succumbed to complications arising from pneumonia and sepsis a month after admission. This case provides valuable insights into the diagnostic challenges and treatment complexities of severe myositis in patients with GPA.

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