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August 3, 2026The Journal of Rheumatology

Look Here, Not There! Vasculitic Myopathy and a Tale of Masquerades

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Authors

CIChinyere IwualaJWJenny WarrenMBMarjorie Bagnas

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Overview

Case report demonstrates challenge in diagnosing muscle weakness in a patient with ANCA-associated vasculitis, highlighting the need for tissue biopsy.

Key Points

  • This report aims to illustrate a rare case of myopathy due to small vessel vasculitis as a presenting feature of ANCA-associated vasculitis.
  • Detailed clinical assessment of a 76-year-old male with myalgias and weakness
  • Auto-antibody testing for identification of positive anti-SRP and anti-MPO ANCA
  • Muscle biopsy performed to confirm the diagnosis.
  • Muscle biopsy revealed a subacute to chronic destructive vasculitic process involving small arteries.
  • Patient's symptoms were primarily due to ANCA-related vasculitis rather than common conditions like PMR or statin-induced myopathy.
  • Activation of multiple autoimmune pathways was indicated by positive auto-antibodies.

Cite This Study

Iwuala et al. (2026) studied this question.

synapsesocial.com/papers/6a70402f75942ff7265e4fc2https://doi.org/10.3899/jrheum.2026-0447.53
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1A Curious Case of Weakness: Antineutrophil Cytoplasmic Antibody-Associated Vasculitis Presenting With Muscle Weakness2024
  2. 2AB1252 VASCULITIS IS A RARE FINDING ON MUSCLE BIOPSY AND DEFINES A UNIQUE CLINICAL SUB-GROUP2024
  3. 3ANCA-associated vasculitis with muscle involvement mimicking polymyalgia rheumatica2024 · 1 citations
  4. 4Myalgia as Initial Presentation of Microscopic Polyangiitis: Diagnostic Utility of Kidney Biopsy2025
  5. 5Isolated muscle vasculitis as a mimic of inflammatory myopathy2026