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Washington University Experience | MUSCLE | Autophagic myopathy | 7A1A (Case 7) H&E 20X 1
Case 7 History ---- The patient is a 63-year-old woman presenting with fatigue, dysphagia, weight loss & respiratory failure with diagnoses of connective tissue diseases (SLE and Sjögren's) treated with prednisone and hydroxychloroquine. EMG showed an irritable myopathy. Serum showed ANA 1:1280, dsDNA 1:80, AChR antibodies, and an IgG kappa M protein. CSF showed a few nucleated cells and a mildly high protein. Mediastinal, hilar and cervical lymph nodes are unremarkable. Rule out immune/inflammatory myopathy. Procedure: right deltoid biopsy ---- 7A1-5 H&E stained sections show skeletal muscle with granular intramysial content. Other areas (see later) consist of mixed lymphohistiocytic/chronic inflammation adjacent to perimysial vessels and in the interstitium between myofibers, along with several foci suggestive of myofiber necrosis and invasion by macrophages. (H&E)
