Isolated proximal weakness of the legs due to neuroborreliosis

2021 ◽  
Vol 14 (11) ◽  
pp. e244431
Author(s):  
Simone Nibourg ◽  
Martijn Beudel ◽  
Jeroen Trip
Keyword(s):  
Differential Diagnosis ◽  
Muscle Weakness ◽  
Neuromuscular Disorders ◽  
Proximal Muscle Weakness ◽  
Proximal Muscle ◽  
Diagnostic Challenge ◽  
Intravenous Antibiotics ◽  
Treatable Condition

Proximal muscle weakness of the legs is a symptom with a broad differential diagnosis. It is mainly caused by neuromuscular disorders and is often a diagnostic challenge. Here, we present a 73-year-old man with isolated proximal weakness of the legs due to lumbar root involvement on the basis of neuroborreliosis. After treatment with intravenous antibiotics he recovered completely. This is the first described case with isolated proximal muscle weakness of the legs due to neuroborreliosis. Despite the fact neuroborreliosis is a rare cause of proximal muscle weakness of the legs, clinicians should include it in their differential diagnosis, especially since it is a treatable condition.

scholarly journals The Pathognomonicity of Gottron’s Sign

2016 ◽  
Vol 8 (1) ◽  
Author(s):  
Heather M. Babcock BSc ◽  
Mohammed S. Osman MD PhD ◽  
Tiffany Kwok MD ◽  
Stephen Chihrin MD ◽  
Stephanie O. Keeling MD MSc ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Connective Tissue ◽  
Muscle Weakness ◽  
Muscle Biopsy ◽  
Connective Tissue Diseases ◽  
Proximal Muscle Weakness ◽  
Erythematous Rash ◽  
Proximal Muscle ◽  
History Of ◽  
Distal Interphalangeal

This article presents the case of a previously healthy 43-year-old female who presented with a 3-month history of progressive, symmetrical, bilateral, proximal muscle weakness accompanied by a violaceous-to-erythematous rash involving her hands, arms, thighs, chest, and face. She had conspicuous non-edematous periorbital violaceous patches with telangiectasia and prominent warm violaceous macules overlying the metacarpophalangeal (MCP) and proximal interphalangeal (PIP) joints. Muscle biopsy confirmed dermatomyositis. Gottron’s sign is the most specific cutaneous finding of dermatomyositis and is present in at least 70% of patients. The lesions begin as non-palpable flat macules or patches (Gottron’s “sign”) or are firm and raised (Gottron’s “papules”), but the lesions eventually coalesce into raised non-blanching plaques that occur over bony prominences – typically the MCP, PIP, and/or distal interphalangeal joints. Gottron’s sign (and papules) are pathognomonic for dermatomyositis, although some other conditions may have similar presentations. Gottron’s sign must always be explained, as dermatomyositis may be primary or secondary to malignancy or other connective tissue diseases, and none of the conditions that make up the differential diagnosis are benign.

scholarly journals Severe proximal myopathy secondary to Hashimoto’s thyroiditis

2019 ◽  
Vol 12 (7) ◽  
pp. e230427
Author(s):  
William Jervis ◽  
Najeeb Shah ◽  
Shiva Kumar Mongolu ◽  
Thozhukat Sathyapalan
Keyword(s):  
Creatine Kinase ◽  
Differential Diagnosis ◽  
Muscle Weakness ◽  
Creatine Kinase Level ◽  
Complete Resolution ◽  
Proximal Muscle Weakness ◽  
Proximal Muscle ◽  
Rare Differential Diagnosis ◽  
Thyroxine Replacement ◽  
Proximal Myopathy

Muscular symptoms in hypothyroidism are common, including myalgia, fatigue and cramps; however, a significantly raised creatine kinase and muscle weakness are rare. Differential diagnosis of patients presenting with muscle weakness and a raised creatine kinase is wide, and hypothyroidism is rarely considered. We report this case of a 30-year-old female presenting with proximal muscle weakness as her primary symptom, hypothyroid symptoms of 3-month duration and a significantly raised creatine kinase. After ruling out other causes of a raised creatine kinase, thyroxine replacement was commenced, which led to complete resolution of her proximal weakness, myalgia and normalisation of creatine kinase level. This case illustrates severe proximal myopathy can be secondary to hypothyroidism, symptoms can resolve with thyroxine replacement and emphasises the importance of measuring thyroid function in patients with proximal weakness/myalgia and a significantly raised creatine kinase.

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 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 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

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.

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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