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Title:          Heart–Lung–Muscle Anti-SAE Syndrome: An Atypical Severe Combination
Subject:        A 78-year-old man with 3 months of progressive dyspnea, dysphony, dysgeusia, and proximal muscle weakness was diagnosed of probably idiopathic inflammatory myopathy with nonspecific interstitial pneumonia. Variable degrees of atrioventricular block and persistently elevated cardiac enzymes indicated a diagnosis of myocarditis, confirmed with cardiac magnetic resonance imaging and endomyocardial biopsy. A comprehensive immune work-up revealed anti-small ubiquitin-like modifier-1 activating enzyme (anti-SAE) antibody, a novel myositis-specific antibody, previously described mainly with overt cutaneous dermatomyositis and late skeletal muscle manifestations. Here, heart–lung–muscle involvement combined with anti-SAE antibodies was a severe combination.
Keywords:       myocarditis; idiopathic inflammatory myopathy; anti-SAE antibody
Author:         Elisabet Zamora, Elena Seder-Colomina, Susana Holgado, Bibiana Quirant-Sanchez, José Luis Mate, Eva M. Martínez-Cáceres, Ivette Casafont and Antoni Bayés-Genís
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