Neuromuscular

Unknowns: "Holey" Muscle fibers

Each of these biopsies shows "holes" in muscle fibers.

What stains would you perform to make the diagnosis?

A
A 64 year old female complains of difficulty swallowing and arising from chairs.
Examination shows asymmetric patchy weakness,
  especially in the quadriceps and hand grip.
Serum CK is 300.


B
A 20 year old male noted muscle discomfort during intense exercise.
Examination shows normal strength, and a tendency to "give way".
Serum CK is 500. EMG is myopathic.


C
A 35 year old male is admitted to the ICU for respiratory failure.
Exam shows a vital capacity of 50% of predicted,
  and weakness of thigh adductors.
Serum CK is 1,465. EMG shows myopathy and fibrillations.


D
An 8 year old female has chronic, slowly progressive weakness.
She was normal until 1.5 years of age.
Examination shows weakness in proximal & facial muscles.
Serum CK is 600.
Cardiac evaluation: Ventricular hypertrophy & R bundle branch block.


E
An 20 year old male is evaluated for myalgias.
Examination shows mild proximal weakness.
Serum CK is 300.


F
A 20 year old male has had several episodes of weakness on awakening.
Now he is having difficulty arising from chairs.
Examination shows mild proximal weakness.
EMG is myopathic.



Return to Muscle biopsy quiz: Home page
Return to Neuromuscular Home Page

12/30/2010