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Necrotising myopathia
Muscle, Lower Extremity
Haematoxylin & Eosin (H&E)
67 years
Skelettal muscle with histomorphological correlations with a necrotising myopathia. Predominance of necrotising muscle fibres and myophagia (CD68). Presence of muscle fibres with red ragged fibre-like changes. Absence of pronounced lymphocytic infiltrates (CD4, CD8, CD20). No significant accumulation of MHC-class-1 Antigens. Accentuation of necrotising muscle fibres with Anti-MAC immunohistochemistry.
The patient was under therapy with statins and had an acute infection when the symptoms developed. CK was dropping after treatment of the infection and stopping the statin medication. The absence of an accumulation of MHC-class-1 Antigens speaks in favor of a toxic effect rather than an autoimmun-related cause.
Manuel, Schlageter, University of Basel
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