Table of Contents

Washington University Experience | MUSCLE | Autophagic myopathy | 7S4 (Case 7) muscle_037 - Copy

Higher magnification of a dense autophagic inclusion. (electron micrograph) ---- Interpretation NM Division: Abnormal aggregate stains initially suggested the possibility of hydrocloroquine (HCQ) exposure; however, the characteristic elements seen in skeletal muscle in HCQ (i.e., curvilinear bodies) are absent in our material. Autophagic vacuolar myopathy, a conclusion based on the many fibers with LAMP2 immunoreactivity, ultrastructural evidence of vacuolar autophagosomes, and fibers with aggregates and vacuoles that stain for multiple sarcolemmal proteins, such as caveolin-3, (and VCP, not shown) seems a better fit. Ultrastructure showed dense autophagosomes and supports the AVM diagnosis.

---