TY - JOUR T1 - Ascending Paresis as Presentation of an Unusual Association Between Necrotizing Autoimmune Myopathy and Systemic Lupus Erythematosus JO - Reumatología Clínica (English Edition) T2 - AU - García-Reynoso,Marco Julio AU - Veramendi-Espinoza,Liz Eliana AU - Ruiz-Garcia,Henry Jeison SN - 21735743 M3 - 10.1016/j.reumae.2013.12.015 DO - 10.1016/j.reumae.2013.12.015 UR - https://www.reumatologiaclinica.org/en-ascending-paresis-as-presentation-an-articulo-S2173574313001469 AB - A 45-year-old man presented to the emergency room with a 15-day history of myalgia of insidious onset and progressive course. It began with symmetrical weakness and pain in feet and ankles that extended upward to the knees. Later, this progressed to paraparesis with creatine phosphokinase level of 44270U/L and respiratory failure that required mechanical ventilation. Electromyography and muscle biopsy of quadriceps were performed. The patient responded to corticotherapy in pulses and supporting management. The presentation of ascending paresis suggested the diagnosis of Guillain–Barré syndrome. However, the degree of muscle involvement with rhabdomyolysis explains the neurological damage by itself. The biopsy revealed pathological criteria for necrotizing autoimmune myopathy (NAM), as well as other clinical and laboratory evidence. The patient's disease progressed and reached the criteria for systemic lupus erythematosus (SLE). To our best knowledge, this is the first report of the NAM and SLE association. ER -