2021 Volume 33 Issue 1 Pages 55-61
An otherwise healthy 63-year-old woman came to the clinic because of a dropped head after a fall. Polymyositis was initially suspected because the dropped head was associated with the weakness of the cervical extensor and erector spinae muscles and an increase in serum CK level. STIR images of MRI showed a high intensity signal in the subscapularis muscle, and electromyogram showed myogenic changes in the trapezius and subscapularis muscles. Muscle biopsy showed regenerated necrotic fibers on the tissue but no inflammatory cell infiltration, and the patient was diagnosed with anti-SRP antibody-positive necrotic myopathy. She was treated with steroids, tacrolimus, and intravenous immunoglobulin（IVIg）, which improved the serum CK value but not her dropped head condition, which was mainly caused by the proximal muscle weakness. Our finding is valuable since this is the third report demonstrating the extensive neck extensor damage in necrotic myopathy.
