Inclusion body myositis (IBM) is an acquired myopathy of both inflammatory and degenerative nature. Here we report a case of IBM associated with prolonged use of imatinib not reported in the literature so far. An 81 years old male with a history of gastrointestinal stromal tumor (GIST) operated 8 years ago was evaluated for the progressive loss of weight and muscle strength leading to total immobilization in 6 months. He was under imatinib for 8 years despite the remission of GIST. Physical examination disclosed diffuse loss of muscle strength, most prominently involvement of distal upper and proximal lower extremity in an asymmetrical pattern with normal serum creatinine kinase level (CK). Further investigations including bilateral thigh MRI, electromyography (EMG), and PET/CT suggested myositis and degenerative myopathy and ruled out any malignancy. Quadriceps femoris biopsy proved the diagnosis of IBM and no trigger except for imatinib was displayed. Clinical improvement in terms of wieght loss and muscle weakness was achieved after discontinuation of imatinib. Since imatinib is widely used in different conditions, it is important to be aware of even its rare adverse effects. Poor response of IBM to conventional immunosuppressive agents enhances the value of etiology identification to relieve symptoms in addition to supportive care.

Introduction Oral anticoagulants (OAs) are not in routine use during Coronavirus disease (COVID-19). Studies that compare the COVID-19 infection outcome of chronic OA users with their peers of non-OA users are available. To the best of our knowledge, none of these studies evaluated the effect of OA use on the COVID-19 related early admission laboratory parameters and/or length of the hospital stay. So, we will study these here. Methods  This retrospective study was included 2 groups; group 1 (n=62) consisted of OA users, and group 2 (n=75) of age, and sex-matched of OA non-users at the time of COVID-19 diagnosis. Early admission laboratory measures, numbers of comorbidities, length of hospital stay, and outcomes of these patients were recorded and analyzed Results Despite higher numbers of comorbidities in group 1, their serum CRP and D-dimer levels were significantly lower than the group 2. (p<0.05, all). The rate of mortality was higher in group 2 patients, but, it has not reached a statistical significance (p>0.05). Regression analysis showed that OA users (in comparison to non-OA users) had 0.980 and 0.520 times lower serum CRP and D-dimer levels, respectively.   Conclusions This study showed a beneficial effect of OA use on early admission serum CRP, and D-dimer levels, which are important prognostic predictors in COVID-19. Additionally, OA use associated with lesser hospital stay days of COVID-19 patients. These beneficial effects of OA use might help in improving the management of this infection after further dedicated studies in this field.