SHM Converge Scientific Abstract ePoster Gallery-A Quirky Journey: Unraveling the Enigma of Inclusion Body Myositis

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This case report describes sporadic inclusion body myositis (sIBM), a rare inflammatory muscle disease that usually affects adults over 50 and causes slowly progressive weakness, muscle wasting, and dysphagia. The condition has a long average diagnostic delay of about 28 months and currently has no cure.  <br /><br />The patient was a 74-year-old woman with a 10-year history of severe hand pain, worsening weakness in the arms and legs, difficulty gripping objects, and swallowing problems. Her history included sicca complex and fibromyalgia. On exam, she had marked weakness of the intrinsic hand muscles, mild shoulder weakness, proximal thigh weakness, and joint tenderness. Laboratory studies were largely negative for autoimmune disease, though muscle enzymes were mildly elevated. A muscle biopsy from the right vastus lateralis showed inflammatory infiltrates with endomysial T-lymphocyte collections, macrophages, and increased connective tissue, supporting the diagnosis.  <br /><br />Steroid therapy was ineffective, which is typical for sIBM. She had only slight symptomatic improvement with Plaquenil, gabapentin, and tramadol. Over time, she agreed to use a walker, begin physical therapy, and work with speech therapy after building trust with the care team and her family.  <br /><br />The authors emphasize that careful history-taking, physical examination, and biopsy are important to reduce diagnostic delay. Traditional immunosuppressive therapies generally do not work well. Instead, early rehabilitation, assistive devices, and family support are key to maintaining function and quality of life. The discussion also notes emerging research into the disease mechanism, including CD8KLRG1 T cells, anti-cN1A antibodies, and beta-amyloid deposition, reflecting both inflammatory and degenerative processes.

Asset Subtitle

Yifang Song

Meta Tag

Author List Isam Diab, Manisha Piryani, Yifang Song

Category Clinical Vignettes

Concept Sporadic Inclusion Body Myositis

Concept Muscular Involvement

Concept Muscle Biopsy

Concept Swallowing Impairment

Concept Diagnostic Delay

Distinguished Non-Finalist

Presenter Organization Trinity Health System, Steubenville, OH

Presenting Author Yifang Song

Track Adult

Keywords

sporadic inclusion body myositis

sIBM

muscle weakness

dysphagia

muscle biopsy

inflammatory myopathy

diagnostic delay

steroid resistance

physical therapy

assistive devices

Sporadic Inclusion Body Myositis

Muscular Involvement

Muscle Biopsy

Swallowing Impairment

Diagnostic Delay