Comprehensive Case Analysis: Diagnosing and Managing Myositis in Newly Diagnosed Systemic Lupus Erythematosus Patients in Indonesia
Keywords:
Systemic Lupus Erythematosus (SLE), Myositis, Muscle Biopsy, ElectromyocardiographyAbstract
An 18-year-old female with Systemic Lupus Erythematosus (SLE) presented with bilateral thigh pain, fever, and diarrhea three days before admission. Diagnosed with SLE one month earlier, she reported prior symptoms, including joint pain, malar rash, hair loss, and hyperpigmented lesions. Initial investigations revealed elevated transaminase levels (AST 355, ALT 132), positive ANA, decreased complement levels (C3 68, C4 16.8), and raised creatine kinase (619). A muscle biopsy confirmed myositis. The patient was treated with immunosuppressant (a combination of steroids and hydroxychloroquine) and supportive therapy. By the eighth day of hospitalization, her symptoms, especially thigh pain, resolved. Electromyocardiography was done, and the results were normal, indicating therapeutic success. This case highlights the importance of prompt diagnosis and management of myositis as a rare SLE manifestation to achieve favorable outcomes.References
Tiniakou E, Goldman D, Corse A, Mammen A, Petri MA. Clinical and histopathological features of myositis in systemic lupus erythematosus. Lupus Sci Med. 2022 Mar;9(1):e000635.
Izmirly PM, Ferucci ED, Somers EC, et al. Incidence rates of systemic lupus erythematosus in the USA: estimates from a meta-analysis of the Centers for Disease Control and Prevention national lupus registries. Lupus Sci Med. 2021 Dec;8(1):e000614.
Furst DE, Amato AA, Iorga ŞR, Gajria K, Fernandes AW. Epidemiology of adult idiopathic inflammatory myopathies in a U.S. managed care plan. Muscle Nerve. 2012 May;45(5):676–83.
Bitencourt N, Solow EB, Wright T, Bermas BL. Inflammatory myositis in systemic lupus erythematosus. Lupus. 2020 Jun;29(7):776–81.
Fava A, Petri M. Systemic lupus erythematosus: Diagnosis and clinical management. Journal of Autoimmunity. 2019 Jan;96:1–13.
Lazarou IN, Guerne PA. Classification, diagnosis, and management of idiopathic inflammatory myopathies. J Rheumatol. 2013 May;40(5):550–64.
Nagy H, Veerapaneni KD. Myopathy. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 [cited 2023 Dec 17]. Available from: http://www.ncbi.nlm.nih.gov/books/NBK562290/
Iaccarino L, Pegoraro E, Bello L, et al. Assessment of patients with idiopathic inflammatory myopathies and isolated creatine kinase elevation. Autoimmun Highlights. 2014 Dec;5(3):87–94.
Fanouriakis A, Tziolos N, Bertsias G, Boumpas DT. Update οn the diagnosis and management of systemic lupus erythematosus. Ann Rheum Dis. 2021 Jan;80(1):14–25.
Liang Y, Leng RX, Pan HF, Ye DQ. Associated variables of myositis in systemic lupus erythematosus: A cross-sectional study. Med Sci Monit. 2017 May 26;23:2543–9.
Gading S, Wati KDK, Witarini KA, Santoso H, Suwarba IGN. Management of systemic lupus erythematosus with polymyositis overlap syndrome. medicina [Internet]. 2019 Dec 5 [cited 2024 Dec 30];50(3). Available from: https://www.medicinaudayana.org/index.php/medicina/article/view/575
Paramasivam S, Noh MM, Khaing MS, Dahlan IM, Payus AO. An uncommon cause of myalgia: A case report on systemic lupus erythematosus myopathy. Annals of Medicine & Surgery [Internet]. 2022 Mar [cited 2024 Dec 15];75. Available from: https://journals.lww.com/10.1016/j.amsu.2022.103450
Paganoni S, Amato A. Electrodiagnostic evaluation of myopathies. Physical Medicine and Rehabilitation Clinics of North America. 2013 Feb;24(1):193–207.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Nabila Abiyasa Putri, Awalia Awalia

This work is licensed under a Creative Commons Attribution 4.0 International License.
Copyright
The authors who publish in this journal agree to the following requirements:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0) that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors can enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) before and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work. (See The Effect of Open Access)
Privacy Statement
The names and email addresses entered in this journal site will be used exclusively for the stated purposes of this journal and will not be made available for any other purpose or to any other party.
