A Case Series of Four Patients with Inflammatory Myositis Under a General Medicine Unit in a Tertiary Care Centre in South India

Abstract

Background: Inflammatory myositis comprises a spectrum of immune-mediated muscle disorders with varied clinical presentations and outcomes. Limited data exist from general medicine wards in India, especially regarding their real-world management and prognostic factors. Objectives: 1. To describe the clinical profile of four patients admitted with inflammatory myositis. 2. To describe the management strategies including diagnosis and treatment. 3. To describe the outcomes of the affected patients. Methods: In this case series, we included patients diagnosed with inflammatory myositis and admitted under a unit in general medicine in a tertiary care center in South India between 2023 and 2024. Data were extracted from electronic medical records and entered into a clinical research form. The findings were tabulated and discussed. The study was approved by the Institutional Ethics Committee, (IRB Min No.2502155). Results: All patients (n = 4) presented with proximal symmetrical muscle weakness, with symptom duration ranging from 2 to 36 months. Autoantibody profiling revealed: 1. Anti-SRP positivity in 2 patients (suggestive of immune-mediated necrotizing myopathy), 2. Anti-Mi-2 in dermatomyositis, 3. Anti-Ro52 in polymyositis. MRI confirmed inflammatory myositis in most cases, and muscle biopsy correlated with serological findings. All patients received corticosteroids; adjunct therapies included IVIg and cyclophosphamide. Three patients showed good clinical response with no relapse or major complications. One patient succumbed to the illness. Conclusion: Inflammatory myopathies present with heterogeneous clinical and immunological features. Integration of clinical evaluation, serology, MRI, and biopsy is vital for diagnosis. Early immunosuppression, including corticosteroids and second-line agents, can result in favorable outcomes-even in aggressive subtypes like anti-SRP–associated necrotizing myopathy.