Immune-Mediated Necrotizing Myopathy Associated With Myelodysplastic Syndrome

Autoimmune diseases can often be diagnosed in patients with myelodysplastic syndrome (MDS). Here, we review the emerging literature linking MDS and rare presentations of autoimmunity, including myositis. We report a patient case that underscores the consideration of myositis as an autoimmune manifestation of MDS: initial presentation included shoulder pain and fevers, and after concurrent diagnoses of MDS and autoimmune myositis, the patient continued to present periodically with recurrent flares despite immunosuppressive treatment. Timely diagnosis of MDS-associated myositis may be challenging due to concurrent fever and hemolytic anemia. Furthermore, accurate diagnosis must exclude statin-induced myopathy, effect of toxins, or infectious etiologies.