Necrotizing myopathy with pipestem capillaries and minimal cellular infiltration

In 1991, Emslie-Smith and Engel described a distinct form of idiopathic inflammatory myopathy they called “necrotizing myopathy with pipestem capillaries, microvascular deposition of the complement membrane attack complex (MAC) and minimal cellular infiltration.” We describe a patient with exercise-dependent painful myopathy related to a necrotizing myopathy with pipestem capillaries in whom mild cutaneous signs of dermatomyositis were detected 7 years after onset and who subsequently developed multiple cerebral infarcts.

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