case_images: PMC9871974_01
case_images: Histologic section of the skeletal muscle biopsy from the right vastus
  lateralis muscle at 100x power. Findings include scattered necrotic fibers
  and myophagocytosis (white arrows), regenerative myofibers (black arrow),
  and a paucity of inflammatory cells. It is important to note that the
  necrotic myofibrils are in different stages of myonecrosis, myophagocytosis,
  and regeneration.
case_images: 10.1177_23247096221150636-fig1.jpg
case_images: PMC9871974_01_10.1177_23247096221150636-fig1.jpg
case_images: fig1-23247096221150636
case_images: Muscle biopsy of the right vastus lateralis muscle was obtained and showed scattered necrotic fibers, myophagocytosis, regenerative myofibers, and a paucity of inflammatory cells (Figure 1).
case_images: Creatine kinase (U/L) levels over time. It is important to note that the
  patient's creatine kinase levels eventually normalized, indicating
  successful remission of the immune-mediated necrotizing myopathy. Of note,
  the patient was hospitalized and treated with 500 mg methylprednisolone
  intravenous piggyback every 12 hours and discharged with 60 mg prednisone
  orally daily with gradual taper. Methotrexate was initiated at the 4-month
  follow-up at 2.5 mg (4 tablets per week) that was subsequently increased to
  6 tablets per week.
case_images: 10.1177_23247096221150636-fig2.jpg
case_images: PMC9871974_01_10.1177_23247096221150636-fig2.jpg
case_images: fig2-23247096221150636
case_images: Six months status-post discharge, the prednisone dose was gradually tapered by alternating 2.5 mg and 5 mg every other day with a concurrent use of daily methotrexate sodium 2.5 mg (Figure 2).