scholarly journals The patient with Acute Muscular Weakness

2014 ◽  
Vol 13 (1) ◽  
pp. 36-41
Author(s):  
H Constable ◽  
◽  
F Wood ◽  
Kevin Jones ◽  
◽  
...  
Keyword(s):  
Muscle Weakness ◽  
Poor Response ◽  
Response To Treatment ◽  
Muscular Weakness ◽  
Proximal Muscle Weakness ◽  
Proximal Muscle ◽  
Respiratory Muscle Weakness ◽  
Acute Medical Unit ◽  
Life Threatening ◽  
Underlying Pathology

Proximal muscle weakness can present acutely or subacutely to the Acute Medical Unit. Early diagnosis of the underlying pathology is essential due to life threatening complications such as respiratory failure and cardiac disturbances as well as causing significant levels of disability. The diagnosis requires thorough history-taking and examination to discern evidence of true weakness, assess its onset, distribution and severity followed by extensive investigations including a CK level, which if high should raise suspicion of rhabdomyolysis. Assessment of respiratory function should be done promptly to identify patients with associated respiratory muscle weakness and treatment should not be delayed waiting for definitive and confirmatory investigations. Poor response to treatment is unusual when diagnosis is correct; this raises the possibility of an alternative diagnosis.

scholarly journals Juvenile dermatomyositis - A case report with review on oral manifestations and oral health considerations

2018 ◽  
Vol 44 (1) ◽  
pp. 52-61
Author(s):  
Pritesh Ruparelia ◽  
Oshin Verma ◽  
Vrutti Shah ◽  
Krishna Shah
Keyword(s):  
Oral Health ◽  
Muscle Weakness ◽  
Juvenile Dermatomyositis ◽  
Oral Manifestations ◽  
Proximal Muscle Weakness ◽  
Proximal Muscle ◽  
Inflammatory Myositis ◽  
Life Threatening

Juvenile Dermatomyositis is the most common inflammatory myositis in children, distinguished by proximal muscle weakness, a characteristic rash and Gottron’s papules. The oral lesions most commonly manifest as diffuse stomatitis and pharyngitis with halitosis. We report a case of an 8 year old male with proximal muscle weakness of all four limbs, rash, Gottron’s papules and oral manifestations. Oral health professionals must be aware of the extraoral and intraoral findings of this rare, but potentially life threatening autoimmune disease of childhood, for early diagnosis, treatment, prevention of long-term complications and to improve the prognosis and hence, the quality of life for the patient.

scholarly journals A Case of a 34-Year-Old Female with Acute Hypoxemic Respiratory Failure and Proximal Muscle Weakness

2017 ◽  
Vol 2017 ◽  
pp. 1-3
Author(s):  
Alex Diaz ◽  
Surit Sharma
Keyword(s):  
Respiratory Failure ◽  
Muscle Weakness ◽  
Length Of Hospital Stay ◽  
Proximal Muscle Weakness ◽  
Proximal Muscle ◽  
Hypoxemic Respiratory Failure ◽  
Acute Hypoxemic Respiratory Failure ◽  
Wound Botulism ◽  
Life Threatening Illness ◽  
Life Threatening

Wound associated botulism is an unusual presentation. Early detection of this potentially life-threatening illness can significantly shorten length of hospital stay and improve prognosis. We present a case of a 34-year-old female with a history of heroin abuse who presented to the ED with acute respiratory failure, diplopia, and proximal muscle weakness. There was early concern for wound botulism as the instigating process. After discussion with the CDC, she was given equine serum heptavalent botulism antitoxin. Laboratory analysis later confirmed our suspicion. Symptoms improved and the patient was liberated from mechanical ventilation on day 14 and discharged from the hospital on day 23.

Statin-induced necrotising autoimmune myopathy: a rare complication of statin therapy

2021 ◽  
Vol 14 (4) ◽  
pp. e240865
Author(s):  
Muhammad Tauseef Ghaffar ◽  
Avinash Radhakrishna ◽  
Imran Ali ◽  
Byran Whelan
Keyword(s):  
Muscle Weakness ◽  
Rare Complication ◽  
Response To Treatment ◽  
Proximal Muscle Weakness ◽  
Proximal Muscle ◽  
Hmg Coa Reductase ◽  
Muscle Groups ◽  
Autoimmune Myopathy ◽  
Coa Reductase ◽  
Statin Use

Statin-induced necrotising autoimmune myopathy (SINAM), a rare complication of statin use, presents with significant proximal muscle weakness and raised creatine kinase (CK) levels (50–100 times). This is different from other musculoskeletal conditions caused by statin use. Anti-hydroxy-methyl-glutaryl-coenzyme A reductase (HMG-CoA) reductase antibody is usually positive in SINAM and it generally indicates good response to immunosuppressive medications. We report a case of a 52-year-old man who presented with a 2-month history of significant upper and lower extremity proximal muscle weakness and a CK level of >10 000. He was started on atorvastatin for myocardial infarction 3 years ago. MRI pelvis, including proximal thigh, showed diffuse muscle oedema to all muscle groups. Muscle biopsy was suggestive of necrotising myopathy. His HMG-CoA reductase antibody was also positive. His treatment regimen consisted of immunosuppressants, including steroids. He also required extensive physiotherapy and showed response to treatment when reviewed in the outpatient clinic 9 months later.

030 A rapidly progressive dermatomyositis with fatality – lessons to learn

2018 ◽  
Vol 89 (6) ◽  
pp. A13.1-A13
Author(s):  
Fariha Islam ◽  
Abhishek Malhotra ◽  
Anish Sachdev
Keyword(s):  
Muscle Weakness ◽  
Positive Family History ◽  
Muscle Disease ◽  
High Dose ◽  
Proximal Muscle Weakness ◽  
Proximal Muscle ◽  
Course Of Disease ◽  
Underlying Malignancy ◽  
Life Threatening ◽  
History Of

IntroductionWe report a case of dermatomyositis in a 43 year old male who presented with transient mild proximal muscle weakness but died from rapidly progressive pulmonary disease within 3 months of diagnosis.CaseThe patient presented with proximal muscle weakness, arthralgia and classic dermatomyositis rashes. He had a history of Huntington’s disease mutation with a positive family history. He had raised creatine kinase (CK) and electromyography showed myopathic changes. The diagnosis was confirmed by skin and muscle biopsy and positive anti-myositis antibodies; PM-Scl(75), MDA5 and SRP. Screening for underlying malignancy was negative but a CT chest scan showed bilateral areas of reverse halo-opacity suggestive of interstitial lung disease (ILD) although he had no respiratory symptoms at the time. He had input from dermatology, rheumatology and respiratory teams and commenced on prednisone 1 mg/kg with pneumocystis prophylaxis. He underwent bronchoscopy and broncho-alveolar lavage that did not isolate any organisms and cell differential was normal. His muscle weakness had resolved even prior to starting steroids and his CK normalised on high dose prednisolone but he developed progressive shortness of breath that led to a second admission within two months. Repeat CT chest showed extensive bilateral infiltrative disease and pneumo-mediastinum. No infective cause was found. He deteriorated rapidly despite intubation, broad-spectrum antibiotics, steroids and extracorporeal membrane oxygenation. He died whilst being considered for lung transplantation.ConclusionThis case provides valuable lessons. Even in cases of mild muscle disease, the extra-muscular involvement can be severe and life threatening in dermatomyositis. Anti-myositis antibodies can be helpful in predicting the course of disease including extra-muscular involvement. The anti-MDA5 antibodies are associated with amyopathic dermatomyositis associated with a rapidly progressive ILD and often with pneumo-mediastinum and has a poor prognosis as in our case. One should consider more aggressive therapy for these patients from the outset.

scholarly journals ANCA-associated vasculitis and severe proximal muscle weakness

2021 ◽  
pp. 1-3
Author(s):  
Jordan S. Dutcher ◽  
Albert Bui ◽  
Tochukwu A. Ibe ◽  
Goyal Umadat ◽  
Eugene P. Harper ◽  
...  
Keyword(s):  
Muscle Weakness ◽  
Proximal Muscle Weakness ◽  
Proximal Muscle ◽  
Anca Associated Vasculitis

Juvenile dermatomyositis: a case of delayed recognition with unusual complication of nephrocalcinosis

2021 ◽  
Vol 14 (4) ◽  
pp. e241152
Author(s):  
Geminiganesan Sangeetha ◽  
Divya Dhanabal ◽  
Saktipriya Mouttou Prebagarane ◽  
Mahesh Janarthanan
Keyword(s):  
Muscle Weakness ◽  
Juvenile Dermatomyositis ◽  
Inflammatory Myopathy ◽  
Unusual Complication ◽  
Ultrasound Screening ◽  
Proximal Muscle Weakness ◽  
Proximal Muscle ◽  
Calcinosis Cutis ◽  
First Case ◽  
Medullary Nephrocalcinosis

Juvenile dermatomyositis (JDM) is the most common inflammatory myopathy in children and is characterised by the presence of proximal muscle weakness, heliotrope dermatitis, Gottron’s papules and occasionally auto antibodies. The disease primarily affects skin and muscles, but can also affect other organs. Renal manifestations though common in autoimmune conditions like lupus are rare in JDM. We describe a child whose presenting complaint was extensive calcinosis cutis. Subtle features of proximal muscle weakness were detected on examination. MRI of thighs and a muscle biopsy confirmed myositis. Nephrocalcinosis was found during routine ultrasound screening. We report the first case of a child presenting with rare association of dermatomyositis, calcinosis cutis and bilateral medullary nephrocalcinosis.

scholarly journals Dermatomyositis-specifikus autoantitesttel rendelkező és autoantitest-negatív betegeink klinikai jellemzőinek és laboratóriumi paramétereinek összehasonlítása

2015 ◽  
Vol 156 (36) ◽  
pp. 1451-1459 ◽  
Author(s):  
Levente Bodoki ◽  
Dóra Budai ◽  
Melinda Nagy-Vincze ◽  
Zoltán Griger ◽  
Zoe Betteridge ◽  
...  
Keyword(s):  
Muscle Weakness ◽  
Matrix Protein ◽  
Skin Lesions ◽  
Clinical Findings ◽  
Proximal Muscle Weakness ◽  
Proximal Muscle ◽  
Nuclear Matrix Protein ◽  
Specific Antibodies ◽  
Antibody Positivity ◽  
Specific Autoantibody

Introduction: Myositis is an autoimmune disease characterised by proximal muscle weakness. Aim: The aim of the authors was to determine the frequency of dermatomyositis-specific autoantibodies (anti-Mi-2, anti-transcriptional intermediary factor 1 gamma, anti-nuclear matrix protein 2, anti-small ubiquitin-like modifier activating enzyme, anti-melanoma differentiation-associated gene) in a Hungarian myositis population and to compare the clinical features with the characteristics of patients without myositis-specific antibodies. Method: Antibodies were detected using immunoblot and immunoprecipitation. Results: Of the 330 patients with nyositis, 48 patients showed dermatomyositis-specific antibody positivity. The frequency of antibodies in these patients was lower than those published in literature Retrospective analysis of clinical findings and medical history revealed that patients with dermatomyositis-specific autoantibody had more severe muscle weakness and severe skin lesions at the beginning of the disease. Conclusions: Antibodies seem to be useful markers for distinct clinical subsets, for predicting the prognosis of myositis and the effectiveness of the therapy. Orv. Hetil., 2015, 156(36), 1451–1459.

scholarly journals SEVERE PROXIMAL MUSCLE WEAKNESS IN A PATIENT WITH ANKYLOSING SPONDYLITIS WITH MAJOR CLINICAL RESPONSE TO SECUKINUMAB

2021 ◽  
Author(s):  
Lucas Brandão Araujo da Silva ◽  
Matheus Santos Rodrigues Silva ◽  
Aline Capellato Dias Baccaro ◽  
Rafael Giovani Misse ◽  
Clarice Tanaka ◽  
...  
Keyword(s):  
Ankylosing Spondylitis ◽  
Clinical Response ◽  
Muscle Weakness ◽  
Proximal Muscle Weakness ◽  
Proximal Muscle

Proximal Muscle Weakness in 10-year-old Female Gymnast

2017 ◽  
Vol 49 (5S) ◽  
pp. 665
Author(s):  
Peter Waller ◽  
David Lessman ◽  
Philip Skiba
Keyword(s):  
Muscle Weakness ◽  
Proximal Muscle Weakness ◽  
Proximal Muscle
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