case_images: PMC10758405_01
case_images: Histopathological and immunohistochemical analysis (H&E) revealed a significant presence of degenerated, necrotic, and regenerating muscle fibers with heterogeneous sizes (A); Around the perimysium of small blood vessels, there were clusters and infiltration of lymphocytes (B); C5b-9 showed strong positivity on the muscle fiber membrane (C); MHC-I was also expressed on the muscle fiber membrane (D).
case_images: fimmu-14-1301109-g001.jpg
case_images: PMC10758405_01_fimmu-14-1301109-g001.jpg
case_images: f1
case_images: Biopsy of the right biceps brachii muscle showed necrotizing myopathy with minimal local inflammation ( Figure 1 ).
case_images: During treatment with OFA, the patient's CK level declined in line with his absolute B-cell count (A). The MRS scores increased with the decrease of absolute B cell count, but the ADL scores increased significantly, indicating that her ability of daily living was significantly improved (B). ALT and AST levels decreased as the patient's absolute B-cell count decreased, and both normalized by the second dose of OFA (C). OFA, Ofatumumab; CK, Creatine Kinase; MRS, Modified Rankin Scale; ADL, Activity of Daily Living Scale; ALT, Alanine aminotransferase; AST, Aspartate aminotransferase.
case_images: fimmu-14-1301109-g002.jpg
case_images: PMC10758405_01_fimmu-14-1301109-g002.jpg
case_images: f2
case_images: Her activity tolerance continued to improve, and B cell remained at a relatively low level during the use of OFA ( Figure 2 ).