Anti-Ro52 Positive Idiopathic Inflammatory Myopathy Presenting as Dropped Head Syndrome
Abstract: Idiopathic inflammatory myopathies are acquired autoimmune muscle disorders in which serological profiling is central to diagnosis and prognosis. Anti-Ro52 (TRIM21) is the commonest myositis-associated antibody, but is usually detected along with a myositis-specific antibody and is strongly linked to interstitial lung disease. Isolated anti-Ro52 positivity, without any myositis-specific antibody or pulmonary involvement, is uncommon. We report a 40-year-old woman with ten months of insidious, painless, progressive proximal weakness of all four limbs and severe neck extensor weakness producing a dropped head. Examination showed symmetrical proximal weakness of grade 1 to 3 on the Medical Research Council scale, proximal wasting, hypotonia, preserved reflexes and normal sensation. Serum creatine kinase and aldolase were repeatedly normal, and nerve conduction and repetitive nerve stimulation studies unremarkable. Antinuclear antibody was 3+ speckled, and an extended myositis immunoblot was positive only for anti-Ro52 at 3+. Whole-body magnetic resonance imaging showed patchy T2 and STIR hyperintensity with symmetrical fatty infiltration of paraspinal, shoulder girdle, iliopsoas, gluteal and thigh muscles, suggestive of inflammatory myopathy. Chest computed tomography, pulmonary function testing, echocardiography and positron emission tomography revealed no interstitial lung disease or occult malignancy. She improved on corticosteroids and mycophenolate mofetil. Inflammatory myopathy should not be excluded on the basis of a normal creatine kinase alone.
Keywords: Anti-Ro52 antibody; Idiopathic inflammatory myopathy; Dropped head syndrome; Normal creatine kinase; Muscle magnetic resonance imaging
How to Cite?: Dr. Ruksana, Dr. Hariharan S, Dr. Balaji G, "Anti-Ro52 Positive Idiopathic Inflammatory Myopathy Presenting as Dropped Head Syndrome", Volume 15 Issue 10, October 2026, International Journal of Science and Research (IJSR), Pages: 420-423, https://www.ijsr.net/getabstract.php?paperid=SR261006212624, DOI: https://dx.doi.org/10.21275/SR261006212624