Table of Contents
Washington University Experience | MUSCLE | Myopathies with Mitochondrial Pathology | 36A0 Case 36 History
Case 36 History ---- The patient is a 72-year-old woman who presents for evaluation of dropped head and gait changes concerning for inclusion body myositis. Interval laboratory studies demonstrated a normal creatine kinase, minimally elevated aldolase (8.4), positive ANA at 1:320, mildly elevated RNP antibodies (1.3), and positive NT5C1a by Western blot. Of note, she has a history of hypertension, T2DM, hypothyroidism, GERD, dizziness, syncopal episodes, seronegative RA (wrists), chronic neck and back pain due to degenerative disc disease with right sciatica status post lumbar surgery, trochanteric bursitis, bilateral carpal tunnel syndrome status post surgery, osteoarthritis of the shoulders and knees, left shoulder replacement, osteoporosis, pituitary adenoma, and depression. EMG/NCS shows abnormal spontaneous activity with myopathic (small, narrow, polyphasic) appearing motor units in the right mid-cervical paraspinal muscles. This could be seen in an irritable myopathy affecting the paraspinal muscles in this patient with camptocormia. Operative procedure: Left cervical paraspinal and deltoid biopsies. (NM Division history)
