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Washington University Experience | MUSCLE | Ring Fibers | 2A (Case 2) EM006 - Copy

Case 2 History ---- The patient is a 31 year old man with a history of narcolepsy and hyperlipidemia. Approximately 15 years ago, the patient began having muscle cramps in his thighs after running during football practice. Resting improved the cramps, which he described as tightness, but tended to recur while running again. If he continued to be active, he developed some weakness in the lower extremities that lasted approximately 90 minutes after resting. There was no history of cramps at night or after rest. Laboratory values showed an elevated lactate to pyruvate ratio of 49 (normal, 10-20), a normal creatine kinase, and a slightly elevated aldolase of 9.2 (upper limit of normal, 8). Operative procedure: Right quadriceps muscle biopsy. ---- 2A-D In this case the myofibrillar apparatus and its circumferential ring of misoriented elements are well fixed and are accompanied by scattered mitochondria and lipid droplets. (electron micrographs).

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