Effect of intravenous immunoglobulin therapy on anti-NT5C1A antibody-positive inclusion body myositis after successful treatment of hepatitis C: A case report

Motonori Takamiya, Yoshiaki Takahashi, Mizuki Morimoto, Nobutoshi Morimoto, Satoshi Yamashita, Koji Abe

Research output: Contribution to journalArticle

Abstract

Inclusion body myositis (IBM) is the commonest idiopathic inflammatory myopathy of older persons. Pathophysiological mechanism of IBM remains unknown; however, an association of IBM with chronic hepatitis C virus (HCV) infection and serum autoantibodies against skeletal muscle protein 5′-nucleotidase 1A (NT5C1A) has recently been reported. No effective treatment for IBM has yet been developed. We here present a 70-year-old man who was anti-NT5C1A antibody-positive in association with IBM and chronic hepatitis C. The initial treatment of ombitasvir/paritaprevir/ritonavir for his chronic hepatitis C was successful; however, his symptoms of IBM did not improve. On the contrary, his quadriplegic paralysis became more severe and he developed dysphagia. Next, steroid pulse therapy was initiated for IBM and, although his hyper-creatine phosphokinase-emia improved, his symptoms did not; indeed, they worsened. Subsequent intravenous immunoglobulin therapy (IVIg) resulted in obvious improvement in his dysphagia. Thereafter IVIg therapy was repeated at approximately 2-monthly intervals. His dysphagia remained improved for more than 1 year; however, his quadriplegia continued to progress slowly. Although IBM can reportedly be associated with hepatitis C, we inferred that there was no direct relationship between these conditions in our patient because his IBM did not improve after treatment of his hepatitis C. Although his IBM-associated quadriplegia did not improve, IVIg therapy did result in improvement in his dysphagia.

Original languageEnglish
Article number100204
JournaleNeurologicalSci
Volume16
DOIs
Publication statusPublished - Sep 1 2019

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Inclusion Body Myositis
Passive Immunization
Intravenous Immunoglobulins
Hepatitis C
Anti-Idiotypic Antibodies
Deglutition Disorders
Chronic Hepatitis C
Quadriplegia
Therapeutics
Ritonavir
5'-Nucleotidase
Myositis
Muscle Proteins
Virus Diseases
Creatine Kinase
Paralysis
Hepacivirus
Autoantibodies
Skeletal Muscle
Steroids

Keywords

  • Anti-skeletal muscle protein 5′-nucleotidase 1A antibody
  • Chronic hepatitis C
  • Dysphagia
  • Inclusion body myositis
  • Intravenous immunoglobulin therapy

ASJC Scopus subject areas

  • Neurology

Cite this

Effect of intravenous immunoglobulin therapy on anti-NT5C1A antibody-positive inclusion body myositis after successful treatment of hepatitis C : A case report. / Takamiya, Motonori; Takahashi, Yoshiaki; Morimoto, Mizuki; Morimoto, Nobutoshi; Yamashita, Satoshi; Abe, Koji.

In: eNeurologicalSci, Vol. 16, 100204, 01.09.2019.

Research output: Contribution to journalArticle

Takamiya, Motonori ; Takahashi, Yoshiaki ; Morimoto, Mizuki ; Morimoto, Nobutoshi ; Yamashita, Satoshi ; Abe, Koji. / Effect of intravenous immunoglobulin therapy on anti-NT5C1A antibody-positive inclusion body myositis after successful treatment of hepatitis C : A case report. In: eNeurologicalSci. 2019 ; Vol. 16.
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