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Washington University Experience | MUSCLE | Myosin Loss Myopathy | 1A0 Case 1 History
Case 1 History ---- The patient is a 46 year old man with a history of poorly differentiated adenocarcinoma and is status post colectomy and 5 rounds of chemotherapy. After therapy he had thinking problems, malaise, and fatigue progressing to an encephalopathic picture. He was found at an outside hospital to be in diabetic ketoacidosis and have significant pancreatitis with hypertriglyceridemia. He was transferred to the MICU and decompensated requiring intubation. He developed septic shock and after extubation was found to have bilateral lower extremity and right upper extremity weakness and a new severe burning pain. The clinical impression was that of a critical illness myopathy but EMG also showed evidence of changes concerning for mononeuropathy multiplex. Operative procedure: Left sural nerve and left deltoid muscle biopsy. The sural nerve biopsy showed active axonal degeneration and is shown in the PNS section..
