{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T22:51:25Z","timestamp":1777762285872,"version":"3.51.4"},"reference-count":14,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,1,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>A percutaneous conchotome muscle biopsy, which is a semi-open technique, provides significant diagnostic yield, especially for inflammatory myopathies. In patients with small vessel vasculitis, muscle involvement could sometimes be the sole or most prominent organ involvement. While open muscle biopsy has been reported to be useful for the diagnosis of vasculitis, the diagnostic utility with conchotome muscle biopsy for vasculitis remains unclear. Here, we report four cases in which a conchotome muscle biopsy made a significant contribution to their diagnosis of small vessel vasculitis. All cases presented with myalgia and weakness at the onset of their diseases, and with an elevation of myeloperoxidase antineutrophil cytoplasmic antibodies. Pathological examination of muscle tissues revealed significant inflammatory infiltration with fibrinoid necrosis in perimysial arterioles, measuring 50\u2013100\u00a0mm in diameter, in all of four cases. Disruption of the elastic plates of the arterioles was found with Elastica van Gieson staining in three cases. Low levels of patients\u2019 pain, evaluated with a visual analogue scale (0\u2013100), ranging from 0 to 30, and no occurrence of adverse events in our cases indicated the safety of this technique. All patients were treated successfully with glucocorticoids, with or without immunosuppressants. The conchotome muscle biopsy could yield the pathological features of small vessel vasculitis with minimal invasiveness.<\/jats:p>","DOI":"10.1093\/mrcr\/rxag029","type":"journal-article","created":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T12:37:11Z","timestamp":1774355831000},"source":"Crossref","is-referenced-by-count":0,"title":["Small vessel vasculitis diagnosed with conchotome muscle biopsy: A case series"],"prefix":"10.1093","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6878-1884","authenticated-orcid":false,"given":"Natsuka","family":"Umezawa","sequence":"first","affiliation":[{"name":"Department of Rheumatology, Graduate School of Medical and Dental Sciences, Institute of Science Tokyo , Tokyo ,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4939-0823","authenticated-orcid":false,"given":"Hirokazu","family":"Sasaki","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Graduate School of Medical and Dental Sciences, Institute of Science Tokyo , Tokyo ,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shimpei","family":"Oka","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Graduate School of Medical and Dental Sciences, Institute of Science Tokyo , Tokyo ,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tomoko","family":"Niwano","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Graduate School of Medical and Dental Sciences, Institute of Science Tokyo , Tokyo ,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shinsuke","family":"Yasuda","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Graduate School of Medical and Dental Sciences, Institute of Science Tokyo , Tokyo ,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2026,3,25]]},"reference":[{"key":"2026042910271014600_ref1","doi-asserted-by":"publisher","first-page":"1827","DOI":"10.1136\/ard.2008.101279","article-title":"Modification and validation of the Birmingham vasculitis activity score (version 3)","volume":"68","author":"Mukhtyar","year":"2009","journal-title":"Ann Rheum Dis"},{"key":"2026042910271014600_ref2","doi-asserted-by":"publisher","first-page":"222","DOI":"10.1136\/ard.2006.054593","article-title":"Development and validation of a consensus methodology for the classification of the ANCA-associated vasculitides and polyarteritis nodosa for epidemiological studies","volume":"66","author":"Watts","year":"2007","journal-title":"Ann Rheum Dis"},{"key":"2026042910271014600_ref3","doi-asserted-by":"crossref","first-page":"103029","DOI":"10.1016\/j.autrev.2021.103029","article-title":"Inflammatory muscle involvement in systemic vasculitis: a systematic review","volume":"21","author":"Conticini","year":"2022","journal-title":"Autoimmun Rev"},{"key":"2026042910271014600_ref4","doi-asserted-by":"publisher","first-page":"470","DOI":"10.3899\/jrheum.100390","article-title":"Use of muscle biopsies for diagnosis of systemic vasculitides","volume":"38","author":"Hervier","year":"2011","journal-title":"J Rheumatol"},{"key":"2026042910271014600_ref5","doi-asserted-by":"publisher","first-page":"210","DOI":"10.3109\/03009742.2015.1086431","article-title":"The use of muscle biopsy in the diagnosis of systemic vasculitis affecting small to medium-sized vessels: a prospective evaluation in Japan","volume":"45","author":"Nunokawa","year":"2016","journal-title":"Scand J Rheumatol"},{"key":"2026042910271014600_ref6","doi-asserted-by":"crossref","first-page":"699","DOI":"10.1093\/rheumatology\/keaa233","article-title":"Muscle biopsy in anti-neutrophil cytoplasmic antibody-associated vasculitis: diagnostic yield depends on anti-neutrophil cytoplasmic antibody type, sex and neutrophil count","volume":"60","author":"Lacou","year":"2021","journal-title":"Rheumatol."},{"key":"2026042910271014600_ref7","doi-asserted-by":"publisher","first-page":"377","DOI":"10.1007\/s10067-024-07277-9","article-title":"Impact of glucocorticoids on muscle biopsy findings in antineutrophil cytoplasmic antibody-associated vasculitis","volume":"44","author":"Ueda","year":"2025","journal-title":"Clin Rheumatol"},{"key":"2026042910271014600_ref8","first-page":"1591","article-title":"Percutaneous conchotome muscle biopsy. A useful diagnostic and assessment tool","volume":"28","author":"Dorph","year":"2001","journal-title":"J Rheumatol"},{"key":"2026042910271014600_ref9","doi-asserted-by":"publisher","first-page":"309","DOI":"10.1136\/annrheumdis-2021-221794","article-title":"2022 American College of Rheumatology\/European Alliance of associations for rheumatology classification criteria for eosinophilic granulomatosis with polyangiitis","volume":"81","author":"Grayson","year":"2022","journal-title":"Ann Rheum Dis"},{"key":"2026042910271014600_ref10","doi-asserted-by":"publisher","first-page":"321","DOI":"10.1136\/annrheumdis-2021-221796","article-title":"2022 American College of Rheumatology\/European Alliance of associations for rheumatology classification criteria for microscopic polyangiitis","volume":"81","author":"Suppiah","year":"2022","journal-title":"Ann Rheum Dis"},{"key":"2026042910271014600_ref11","doi-asserted-by":"publisher","first-page":"e12888","DOI":"10.1111\/nan.12888","article-title":"Muscle biopsy practices in the evaluation of neuromuscular disease: a systematic literature review","volume":"49","author":"Ross","year":"2023","journal-title":"Neuropathol Appl Neurobiol"},{"key":"2026042910271014600_ref12","doi-asserted-by":"publisher","first-page":"1163","DOI":"10.1007\/s00296-020-04567-8","article-title":"Eosinophilic granulomatosis with polyangiitis presenting with myositis: case based review","volume":"40","author":"Koppikar","year":"2020","journal-title":"Rheumatol Int"},{"key":"2026042910271014600_ref13","doi-asserted-by":"publisher","first-page":"397","DOI":"10.1007\/s00256-007-0409-0","article-title":"MRI appearance of muscle denervation","volume":"37","author":"Kamath","year":"2008","journal-title":"Skeletal Radiol"},{"key":"2026042910271014600_ref14","doi-asserted-by":"publisher","first-page":"179","DOI":"10.1016\/j.alit.2022.08.004","article-title":"Development of vasculitis in a case with severe asthma treated with benralizumab and low-dose corticosteroid","volume":"72","author":"Umezawa","year":"2023","journal-title":"Allergol Int"}],"container-title":["Modern Rheumatology Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/mrcr\/advance-article-pdf\/doi\/10.1093\/mrcr\/rxag029\/67507984\/rxag029.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/mrcr\/article-pdf\/10\/1\/rxag029\/67507984\/rxag029.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/mrcr\/article-pdf\/10\/1\/rxag029\/67507984\/rxag029.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T14:27:23Z","timestamp":1777472843000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/mrcr\/article\/doi\/10.1093\/mrcr\/rxag029\/8540218"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026]]},"references-count":14,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1,6]]}},"URL":"https:\/\/doi.org\/10.1093\/mrcr\/rxag029","relation":{},"ISSN":["2472-5625"],"issn-type":[{"value":"2472-5625","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026]]},"published":{"date-parts":[[2026]]},"article-number":"rxag029"}}