Anti-SRP myositis: a diagnostic and therapeutic challenge

Background. Anti-signal recognition protein (anti-SRP) myopathy is a rare idiopathic inflammatory myopathy in children. Herein, a 3-year-old patient with severe anti-SRP myopathy showing a rapidly progressive disease course is presented in order to increase the awareness of pediatricians about idio...

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Main Authors: Merve Cansu Polat, Didem Ardıçlı, Banu Çelikel Acar, Beril Talim, Nesrin Şenbil, Elif Çelikel
Format: Article
Language:English
Published: Hacettepe University Institute of Child Health 2024-12-01
Series:The Turkish Journal of Pediatrics
Subjects:
Online Access:https://turkjpediatr.org/article/view/4916
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author Merve Cansu Polat
Didem Ardıçlı
Banu Çelikel Acar
Beril Talim
Nesrin Şenbil
Elif Çelikel
author_facet Merve Cansu Polat
Didem Ardıçlı
Banu Çelikel Acar
Beril Talim
Nesrin Şenbil
Elif Çelikel
author_sort Merve Cansu Polat
collection DOAJ
description Background. Anti-signal recognition protein (anti-SRP) myopathy is a rare idiopathic inflammatory myopathy in children. Herein, a 3-year-old patient with severe anti-SRP myopathy showing a rapidly progressive disease course is presented in order to increase the awareness of pediatricians about idiopathic inflammatory myopathies. Case Presentation. A previously healthy 3-year-old girl presented with progressive symmetrical proximal muscle weakness that caused difficulty in climbing stairs for two months prior to evaluation, and a marked elevation of the serum creatine kinase levels. A skeletal muscle biopsy revealed necrotic and regenerating processes, with mild inflammatory changes. Myositis-specific and associated autoantibodies tested by the immunoblot method were positive for anti-SRP. Pulse corticosteroid, intravenous immunoglobulin, and methotrexate were administered. However, muscle weakness progressed, respiratory distress and dysphagia developed. Rituximab was initiated. While on rituximab treatment, she was able to walk independently and muscle enzymes were within normal range at the 15th month of diagnosis. Conclusion. Early diagnosis of patients with anti-SRP myositis is important to control inflammation and prevent disease progression and complications. To our knowledge, our patient is the youngest case reported in the literature and was successfully treated with rituximab added to conventional therapy.
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issn 0041-4301
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language English
publishDate 2024-12-01
publisher Hacettepe University Institute of Child Health
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series The Turkish Journal of Pediatrics
spelling doaj-art-d7d27c370b2345a8ae54bffa8fcf3cfd2025-08-20T02:01:50ZengHacettepe University Institute of Child HealthThe Turkish Journal of Pediatrics0041-43012791-64212024-12-0166610.24953/turkjpediatr.2024.4916Anti-SRP myositis: a diagnostic and therapeutic challengeMerve Cansu Polat0https://orcid.org/0000-0003-3279-8435Didem Ardıçlı1https://orcid.org/0000-0001-7054-3623Banu Çelikel Acar2https://orcid.org/0000-0002-1808-3655Beril Talim3https://orcid.org/0000-0003-2375-7543Nesrin Şenbil4https://orcid.org/0000-0002-4143-3553Elif Çelikel5https://orcid.org/0000-0003-0129-4410Division of Pediatric Rheumatology, Department of Pediatrics, University of Health Sciences, Ankara Bilkent City Hospital, Ankara, TürkiyeDivision of Pediatric Neurology, Department of Pediatrics, University of Health Sciences, Ankara Bilkent City Hospital, Ankara, TürkiyeDivision of Pediatric Rheumatology, Department of Pediatrics, University of Health Sciences, Ankara Bilkent City Hospital, Ankara, TürkiyePediatric Pathology Unit, Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, TürkiyeDivision of Pediatric Neurology, Department of Pediatrics, Kırıkkale University Faculty of Medicine, Kırıkkale, TürkiyeDivision of Pediatric Rheumatology, Department of Pediatrics, University of Health Sciences, Ankara Bilkent City Hospital, Ankara, Türkiye Background. Anti-signal recognition protein (anti-SRP) myopathy is a rare idiopathic inflammatory myopathy in children. Herein, a 3-year-old patient with severe anti-SRP myopathy showing a rapidly progressive disease course is presented in order to increase the awareness of pediatricians about idiopathic inflammatory myopathies. Case Presentation. A previously healthy 3-year-old girl presented with progressive symmetrical proximal muscle weakness that caused difficulty in climbing stairs for two months prior to evaluation, and a marked elevation of the serum creatine kinase levels. A skeletal muscle biopsy revealed necrotic and regenerating processes, with mild inflammatory changes. Myositis-specific and associated autoantibodies tested by the immunoblot method were positive for anti-SRP. Pulse corticosteroid, intravenous immunoglobulin, and methotrexate were administered. However, muscle weakness progressed, respiratory distress and dysphagia developed. Rituximab was initiated. While on rituximab treatment, she was able to walk independently and muscle enzymes were within normal range at the 15th month of diagnosis. Conclusion. Early diagnosis of patients with anti-SRP myositis is important to control inflammation and prevent disease progression and complications. To our knowledge, our patient is the youngest case reported in the literature and was successfully treated with rituximab added to conventional therapy. https://turkjpediatr.org/article/view/4916anti-signal recognition protein myopathyanti-SRPrituximabinflammatory myopathychildren
spellingShingle Merve Cansu Polat
Didem Ardıçlı
Banu Çelikel Acar
Beril Talim
Nesrin Şenbil
Elif Çelikel
Anti-SRP myositis: a diagnostic and therapeutic challenge
The Turkish Journal of Pediatrics
anti-signal recognition protein myopathy
anti-SRP
rituximab
inflammatory myopathy
children
title Anti-SRP myositis: a diagnostic and therapeutic challenge
title_full Anti-SRP myositis: a diagnostic and therapeutic challenge
title_fullStr Anti-SRP myositis: a diagnostic and therapeutic challenge
title_full_unstemmed Anti-SRP myositis: a diagnostic and therapeutic challenge
title_short Anti-SRP myositis: a diagnostic and therapeutic challenge
title_sort anti srp myositis a diagnostic and therapeutic challenge
topic anti-signal recognition protein myopathy
anti-SRP
rituximab
inflammatory myopathy
children
url https://turkjpediatr.org/article/view/4916
work_keys_str_mv AT mervecansupolat antisrpmyositisadiagnosticandtherapeuticchallenge
AT didemardıclı antisrpmyositisadiagnosticandtherapeuticchallenge
AT banucelikelacar antisrpmyositisadiagnosticandtherapeuticchallenge
AT beriltalim antisrpmyositisadiagnosticandtherapeuticchallenge
AT nesrinsenbil antisrpmyositisadiagnosticandtherapeuticchallenge
AT elifcelikel antisrpmyositisadiagnosticandtherapeuticchallenge