クレアチンキナーゼが高値遷延した抗SRP抗体陽性筋炎の症例に対する回復期リハビリテーション病棟での治療経験

抄録

Anti-signal recognition particle myositis (ASRPM) is a steroid-resistant disease that develops in approximately 5-8％ of patients with dermatomyositis, polymyositis, or other types of myositis. It restricts the patient's activities of daily life (ADLs), mainly owing to muscle weakness of the trunk and proximal lower extremities. We report a case of ASRPM treated at a Kaifukuki rehabilitation ward (KRW；a type of inpatient rehabilitation ward in Japan). A female ASRPM patient in her eighties underwent treatment at the KRW twice, with an interval of 18 months between treatments. During each hospital stay, concentrative and graded exercise therapy was performed under continuous administration of steroid and tacrolimus hydrate. The severity of ASRPM was evaluated using periodic measurement of creatinine kinase (CK) levels. After each KRW treatment, the patient gained the ability to walk and perform instrumental ADLs to live alone. The details of exercise therapy for ASRPM and the management of ASRPM and steroid-induced osteoporosis and its complications (for e.g., lumbar compression fracture) are also discussed.