An Italian team reports a case of autoimmune necrotising myopathy occurring in the context of active tuberculosis in a 38-year-old migrant:
- the patient, originally from Bangladesh, had arrived in Italy via the Balkan route,
- he presented with the classic signs of active pulmonary tuberculosis but also with severe myalgia that had been developing for several years,
- laboratory tests confirmed the presence of tuberculosis as well as immune-mediated necrotising myopathy, both on muscle biopsy and following the discovery of seropositivity for HMGCR antibodies.
- anti-tuberculosis treatment proved to be very effective for both types of manifestations.
The authors establish a cause-and-effect relationship, as Koch’s bacillus may, in this case, be the antigen triggering the immune reaction against the muscle.
