{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,19]],"date-time":"2025-11-19T09:39:26Z","timestamp":1763545166716,"version":"3.44.0"},"reference-count":13,"publisher":"BMJ","issue":"4","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Pract Neurol"],"accepted":{"date-parts":[[2022,11,27]]},"published-print":{"date-parts":[[2023,8]]},"abstract":"<jats:p>We describe an unusual presentation of myeloperoxidase positive antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis managed by a multidisciplinary approach. A 75-year-old man gave a 3-week history of proximal lower limb weakness and exertional myalgia. His serum creatine kinase was normal and many of his non-specific symptoms suggested small vessel vasculitis. His investigations for common causes of muscle weakness were normal, and renal biopsy was normal despite haemoproteinuria. CT scan of the chest identified a pulmonary nodule of uncertain significance, not amenable to biopsy. MR scan of the thighs showed muscle oedema, and muscle biopsy confirmed typical features of vasculitis. Following high-dose corticosteroids his exertional myalgia quickly resolved and his normal mobility returned. Early immunosuppression is essential to improving clinical outcomes in ANCA-associated vasculitis, but diagnostic investigations often lack sensitivity.<\/jats:p>","DOI":"10.1136\/pn-2022-003536","type":"journal-article","created":{"date-parts":[[2022,12,22]],"date-time":"2022-12-22T13:20:34Z","timestamp":1671715234000},"page":"310-313","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Myeloperoxidase-positive ANCA-associated vasculitis presenting as myalgia, proximal weakness and a normal CK"],"prefix":"10.1136","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5661-6267","authenticated-orcid":false,"given":"Mark Peter","family":"Maskery","sequence":"first","affiliation":[{"name":"Department of Neurology, Lancashire Teaching Hospitals NHS Foundation Trust, Preston, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel","family":"Whittam","sequence":"additional","affiliation":[{"name":"Department of Neurology, Lancashire Teaching Hospitals NHS Foundation Trust, Preston, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Subedi","family":"Nawaraj","sequence":"additional","affiliation":[{"name":"Department of Radiology, Lancashire Teaching Hospitals NHS Foundation Trust, Preston, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shrijeet","family":"Chakraborti","sequence":"additional","affiliation":[{"name":"Department of Pathology, Lancashire Teaching Hospitals NHS Foundation Trust, Preston, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chera","family":"Arunachalam","sequence":"additional","affiliation":[{"name":"Department of Renal Medicine, Lancashire Teaching Hospitals NHS Foundation Trust, Preston, 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