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Washington University Experience | MUSCLE | Focal Hypercontraction | 2A0 Case 2 History
Case 2 History ---- The patient is a 27-year-old woman with a history of schizoaffective disorder and asthma presenting with new-onset myalgias and rash, found to have markedly elevated CK (>120,000) and aldolase (>700), undergoing evaluation for myositis and immune-mediated myopathy. She reports significant physical exhaustion associated with prolonged walking and increased occupational demands at a new job. The significant pathologic findings include numerous fibers undergoing necrosis with macrophages immediately adjacent. Scattered muscle fibers show subsarcolemmal and interfibrillar mitochondria present in large numbers with mild abnormal contours but lacking giant mitochondria, ring forms, and parking lot inclusions. Scattered lipofuscin aggregates are often associated with these clusters.
