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Washington University Experience | MUSCLE | Hydroxychloroquine myopathy | 5A0 Case 5 History
Case 5 History ---- The patient is a 67 year old woman with a history of MALT lymphoma with diffuse subcutaneous skin lesions involving upper and lower extremities initially diagnosed in March 2011. Her history was also significant for an autoimmune disease, a positive ANA and symptoms of a rheumatologic condition (stiffness, dry eyes and mouth). She was treated with Plaquenil and Lodine, and oral weekly methotrexate for joint arthralgias and suspected dermatomyositis. Her recent neurologic examination shows mildly reduced hip flexor strength, not fatigable, with mildly diminished proprioception and brisk reflexes. Her CK was normal and aldolase was mildly elevated. She has shown overall improvement with prednisone (10mg daily). By report she has no inflammatory cells or perifascicular atrophy in her current muscle biopsy workup. Nonetheless, electron microscopy was performed to look for tubuloreticular inclusions (TRI) expected in dermatomyositis.
