Marked Efficacy of a Therapeutic Strategy in a Patient With Necrotizing Myopathy Associated With Anti-signal Recognition Particle (SRP) Autoantibodies

Necrotizing autoimmune myopathy (NAM) is a rare muscular disorder characterized by severe proximal muscle weakness. Risk factors include statin use, malignancy, and connective tissue diseases. The current study presents the first case of NAM in Saudi Arabia in a 26-year-old female who presented with proximal upper and lower limb weakness, dysphagia, dysarthria, and dyspnea with no previous medical or surgical history and was not on medication. Targeted myopathic antibody analysis revealed antibodies to signal recognition particles (SRP), and the serum creatinine kinase level reached 9308 U/L. A diagnosis of NAM was made, and the patient was started on the management plan. We discussed an interesting case progression and adverse effect challenges, as well as the management of these difficult-to-treat conditions.