9. Respiratory Complications: A Late Stage Manifestation of HIBM

Respiratory complications may arise in the later stages of HIBM, as the disease begins to affect the muscles involved in breathing. While not as common as other symptoms, respiratory involvement in HIBM can have severe consequences, making it a crucial symptom to understand and monitor.
Breathing is a largely automatic process, controlled by several muscles that work in harmony to inhale and exhale air. In HIBM, as the disease progresses, the weakness can affect these muscles, leading to breathing difficulties. Symptoms can range from shortness of breath during physical activities, to trouble breathing while lying flat, or even respiratory failure in severe cases.
Given the potential severity of this symptom, regular monitoring of respiratory function is recommended for individuals with HIBM. Early signs of respiratory involvement should be discussed promptly with healthcare providers, who can initiate suitable interventions to support breathing, such as physiotherapy exercises or mechanical ventilation in severe cases. (9)