myopathy b9402040 許瑜真. myopathy inflammatory disorders endocrine disorders electrolyte...
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Myopathy
B9402040 許瑜真
Myopathy
• Inflammatory disorders• Endocrine disorders• Electrolyte disorders• Metabolic myopathies• Drugs and toxins• Infections • Rhabdomyolysis
Myositis (Inflammatory disorders)
• 會出現 systemic rheumatic disease的症狀– scleroderma– systemic lupus erythematosus
• Muscle biopsy • “Myositis specific" antigens– Ex. anti-histidyl-t-RNA synthase [anti-Jo-1]
Endocrinopathy (Endocrine disorders)
• Hypothyroidism• Cushing's syndrome (or exogenous steroid
administration)
Electrolyte disorders
• Hypokalemia• Hypophosphatemia• Hypocalcemia• Hypernatremia or hyponatremia
Metabolic myopathy
• Recurrent episodes of exertion-related pigmenturia and weakness
• Slowly progressive rather than episodic course• Muscle biopsy – Special stains can demonstrate enzyme
deficiencies and abnormal accumulations of glycogen or lipid
Drug-induced myopathy
• Medication, alcohol, or substance-abuse
Infections
• Viral– influenza, parainfluenza, Coxsachie, HIV,
cytomegalovirus, echovirus, adenovirus, Epstein Barr virus
• Bacterial– pyomyositis, lyme myositis
• Fungal• Parasitic– trichinosis, toxoplasmosis
Rhabdomyolysis
• Serum muscle enzymes– creatine kinase >100,000 IU/L– aldolase, lactate dehydrogenase, and the
aminotransferases• Myoglobinuria– urine blood (+)– RBCs in the sediment (-)
• Electrolyte abnormalities• Acute renal failure