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Muscle weakness is rarely a presenting symptom of anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV), although the disease frequently involves the lungs, skin, neurons, and kidneys. Here we describe a case of AAV presenting with muscle weakness in which only muscle biopsy could confirm the diagnosis. The literature review, including three similar cases, suggested that patients with ANCA-associated muscle vasculitis likely had myalgia, normal levels of creatine kinase, pulmonary fibrosis, rheumatoid factor, and muscle edema on MRI.

Lupus myelitis (LM) is a rare but serious complication of systemic lupus erythematosus (SLE). In 2009, Birnbaum et al. suggested that LM could be classified into two subtypes, namely gray and white matter myelitis, based on neurological examination findings. Here we describe three cases of this disorder, one with signs of white matter dysfunction and two with signs of gray matter dysfunction. We discuss the potential role of autoantibodies in the development of LM., Competing Interests: Conflict of Interest: No conflict of interest was declared by the authors.

Competing Interests: Dr. Oiwa reports personal fees from Daiichi Sankyo, during the conduct of the study.