Case 6 History ---- The patient was a 63 year old woman with a history of rheumatoid arthritis and recent 75 pound weight loss, who complained of weakness in both legs since December 2021 and has used a walker since January of 2022. She experiences occasional tingling in the left leg. Electromyography suggests mixed myogenic and neurogenic potentials and nerve conduction studies show sensory-motor axonal neuropathy with absent sural SNAPs, and normal brain imaging. CK is elevated at 64. AChR antibodies are negative. ANA is homogenous positive at 1:320 and has been as high as 1:1280. Rheumatoid factor is 324. Immunofixation shows no M-protein. Rule out inclusion body myositis. Operative procedure: Left quadriceps muscle biopsy
