Association between antiphospholipid syndrome and polymyositis

Abstract

Antiphospholipid syndrome (APS) can be primary or secondary to several conditions such as neoplasias, infectious diseases, drugs, or even to other autoimmune diseases. Only few studies have reported the association between APS and polymyositis (PM) The patient was a 52-year-old male complaining of proximal muscle weakness. On the occasion, the patient showed increased level of muscle enzymes. Electromyography and biopsy of muscle were compatible with inflammatory myopathy. Based on hypothesis of PM, prednisone (1mg/kg/day) was initiated. One year after, the patient had deep venous thrombosis of lower limb and acute mesenteric ischemia. The anticardiolipin IgM level was elevated confirming the diagnosis of APS. The patient had been treated by prednisone (10mg/day) and warfarine. After 6 years, he presented a sudden onset of focal neurologic deficit resulting from arterial brain infarction. APS can be associated with a wide range of diseases. The concomitance of APS and PM has been rarely reported, and only five cases have been described in the literature. The association of anticoagulation and corticoids treatment reduces the risk of recurrence thromboembolic accidents, but refractory myopathy is possible.