Tonsillectomy Improved Therapeutic Response in Anti-SRP Myopathy With Chronic Tonsillitis

Takuya Ikeda, Hideyuki Takeuchi, Keita Takahashi, Haruko Nakamura, Misako Kunii, Atsuko Katsumoto, Mikiko Tada, Yuichi Higashiyama, Takashi Hibiya, Shigeaki Suzuki, Ichizo Nishino, Shigeru Koyano, Hiroshi Doi, Fumiaki Tanaka

Research output: Contribution to journalArticlepeer-review


Chronic tonsillitis has been attracted attention as a source of abnormal immune responses and a possible trigger of autoimmune diseases such as IgA nephritis, IgA vasculitis, palmoplantar pustulosis, psoriasis, rheumatoid arthritis, Behçet’s disease, and myositis. Here we present the first report of anti–signal recognition particle antibody–associated necrotizing myopathy (anti-SRP myopathy) with IgA nephropathy and chronic tonsillitis in which the therapeutic response to intravenous immunoglobulin (IVIG) treatment was dramatically improved after tonsillectomy and accompanied by a rapid increase in ΔIgG, defined as the change in serum IgG levels 2 weeks after the start of IVIG treatment relative to pre-treatment levels. Moreover, serum anti-SRP antibody titers became undetectable after tonsillectomy even though the resected tonsils did not produce anti-SRP antibodies. Tonsillectomy should be considered when chronic tonsillitis is observed in patients with autoimmune diseases showing poor response to treatment, including anti-SRP myopathy.

Original languageEnglish
Article number595480
JournalFrontiers in Immunology
Publication statusPublished - 2020 Nov 24


  • IgA nephritis
  • anti-SRP myopathy
  • chronic tonsillitis
  • intravenous immunoglobulin
  • tonsillectomy

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology


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