BACKGROUND Necrotizing myopathy (NM) is defined by the dominant pathological feature of necrosis of muscle fibers without substantial lymphocytic inflammatory infiltration. Anti-signal recognition particle (SRP)-antibody-positive myopathy is related to NM. Anti-SRP-antibody-positive myopathy can comorbid with other disorders in some patients, however, comorbidity with malignant tumor and myopericarditis has still not been reported. CASE PRESENTATION An 87-year-old woman with dyspnea on exertion and leg edema was referred to our hospital because of suspected heart failure and elevated serum creatine kinase level. Upon hospitalization, she developed muscle weakness predominantly in the proximal muscles. Muscle biopsy and immunological blood test led to the diagnosis of anti-SRP-antibody-positive myopathy. A colon carcinoma was also found and surgically removed. The muscle weakness remained despite the tumor resection and treatment with methylprednisolone. Cardiac screening revealed arrhythmia and diastolic dysfunction with pericardial effusion, which recovered with intravenous immunoglobulin (IVIg) treatment. CONCLUSIONS We reported the first case of anti-SRP-positive myopathy comorbid with colon carcinoma and myopericarditis. This case is rare in the point that heart failure symptoms were the first clinical presentation. The underlying mechanism is still not clear, however, physicians should be carefully aware of the neoplasm and cardiac involvement in anti-SRP-antibody positive-myopathy patients and should consider farther evaluation and management.

中文翻译：

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抗SRP抗体阳性的肌病的继发性心脏受累：以心衰症状为首的87岁女性为首例临床表现。

背景技术坏死性肌病（NM）由肌肉纤维坏死的主要病理特征定义，而没有实质性的淋巴细胞炎性浸润。抗信号识别颗粒（SRP）-抗体阳性肌病与NM有关。抗SRP抗体阳性的肌病可以与某些患者的其他疾病并存，但是，尚无与恶性肿瘤和心肌炎合并症的报道。病例介绍一名因劳累和腿部浮肿而呼吸困难的87岁妇女因怀疑心力衰竭和血清肌酸激酶水平升高而被转诊至我院。住院后，她主要在近端肌肉中出现肌肉无力。肌肉活检和免疫血液检查导致抗SRP抗体阳性肌病的诊断。还发现了结肠癌，并通过手术将其切除。尽管进行了肿瘤切除和甲基泼尼松龙治疗，肌肉无力仍然存在。心脏筛查发现心包积液导致心律不齐和舒张功能障碍，经静脉免疫球蛋白（IVIg）治疗后可恢复。结论我们报道了第一例抗SRP阳性肌病合并结肠癌和肌心膜炎。这种情况很少见，因为心力衰竭症状是首例临床表现。潜在的机制尚不清楚，但是，医生应仔细了解抗SRP抗体阳性肌病患者的肿瘤和心脏受累情况，并应考虑进行进一步的评估和管理。尽管进行了肿瘤切除和甲基泼尼松龙治疗，肌肉无力仍然存在。心脏筛查发现心包积液导致心律不齐和舒张功能障碍，经静脉免疫球蛋白（IVIg）治疗后可恢复。结论我们报道了第一例抗SRP阳性肌病合并结肠癌和肌心膜炎。这种情况很少见，因为心力衰竭症状是首例临床表现。潜在的机制尚不清楚，但是，医生应仔细了解抗SRP抗体阳性肌病患者的肿瘤和心脏受累情况，并应考虑进行进一步的评估和管理。尽管进行了肿瘤切除和甲基泼尼松龙治疗，肌肉无力仍然存在。心脏筛查发现心包积液导致心律不齐和舒张功能障碍，经静脉免疫球蛋白（IVIg）治疗后可恢复。结论我们报道了第一例抗SRP阳性肌病合并结肠癌和肌心膜炎。这种情况很少见，因为心力衰竭症状是首例临床表现。潜在的机制尚不清楚，但是，医生应仔细了解抗SRP抗体阳性肌病患者的肿瘤和心脏受累情况，并应考虑进行进一步的评估和管理。经静脉免疫球蛋白（IVIg）治疗后恢复。结论我们报道了第一例抗SRP阳性肌病合并结肠癌和肌心膜炎。这种情况很少见，因为心力衰竭症状是首例临床表现。潜在的机制尚不清楚，但是，医生应仔细了解抗SRP抗体阳性肌病患者的肿瘤和心脏受累情况，并应考虑进行进一步的评估和管理。经静脉免疫球蛋白（IVIg）治疗后恢复。结论我们报道了第一例抗SRP阳性肌病合并结肠癌和肌心膜炎。这种情况很少见，因为心力衰竭症状是首例临床表现。潜在的机制尚不清楚，但是，医生应仔细了解抗SRP抗体阳性肌病患者的肿瘤和心脏受累情况，并应考虑进行进一步的评估和管理。