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Myopathy, Endocrine

Endocrine Myopathies


Presentation

  • Presentations range anywhere from acute, painful, and necrotic myopathies, as can occur in statin myopathy, to more insidious presentations such as steroid myopathy.[ncbi.nlm.nih.gov]
  • Common clinical presentations of the endocrine myopathies are highlighted, along with diagnostic evaluation and treatments.[ncbi.nlm.nih.gov]
  • Fiber degeneration and necrosis are present. Serum muscle enzymes are characteristically elevated. By the end of the second week, a 15% to 50% eosinophilia is present. Serologic tests become positive by the end of the third week. 2.[78stepshealth.us]
  • Presentation on theme: "Dystrophies, Inflammatory myopathies & endocrine myopathies"— Presentation transcript: 1 Dystrophies, Inflammatory myopathies & endocrine myopathies 2 Classification of Myopathies A.[slideplayer.com]
Constitutional Symptom
  • Polymyalgia rheumaticc presents in patients over 50 with proximal soreness and stiffness and constitutional symptoms. It may be associated with temporal arteritis .[78stepshealth.us]
Periorbital Edema
  • By the end of the first week, patients may have fever, periorbital edema, conjunctivitis, muscle pain and tenderness, and an erythematous maculopapular rash. Muscle weakness may be mild but is often quite severe. Muscle invasion may last 6 weeks.[78stepshealth.us]
Muscular Atrophy
  • Duchenne in 1855 first described a progressive muscular atrophy of childhood and was termed “hypertrophic paraplegia of infancy”.[slideplayer.com]
  • Spinal muscular atrophy. Congenital hypomyelinating neuropathies. It may be difficult to distinguish myopathy from peripheral neuropathy.[patient.info]
  • In these cases it is necessary to differentiate TM not only with muscular dystrophy (oculopharengeal (oculopharyngeal) form) but as well with proximal spinal muscular atrophy (PSMA) [13] .[scirp.org]
  • atrophy Endocrine myopathy: Cushing’s syndrome Hyper or hypo- thyroidism Hyper- or hypo- parathyroidism Drug induced myopathy : True myositis: Penicillamine, Procainamide Zidovudine (a form of mitochondrial myopathy) Glucocorticoids Statins: Lovastatin[learningneurology.com]
  • atrophy Adrenomyeloneuropathy Recovery from severe malnutrition & weight loss Pectoral muscle hypertrophy Gonadal Disorders Dysgenesis Ataxia & Pyramidal syndrome : COX10 HMSN Minifascicles HSN Minifascicles & Mental retardation Hypogonadism Hereditary[neuromuscular.wustl.edu]
Foot Deformity
  • Deformities 510 Case 81 A Woman with Droopy Eyelids and Ophthalmoplegia 515 Case 82 A Man with Weakness and Swelling in the Neck 522 Case 83 A Woman with Muscle Pains and Dark Urine 526 Case 84 A Woman with Progressive Proximal Muscle Weakness 533 Case[books.google.com]
Leg Pain
  • […] with Proximal Weakness 448 Case 72 A Young Woman with Distal Upper Extremity Weakness 454 Case 73A A Young Man with Episodic Weakness 464 Case 73B An African American Man with Hyperthyroidism and Acute Paralysis 470 Case 74 A Boy with Large Muscles Leg[books.google.com]

Workup

  • A neurologic examination that shows deficits in a single nerve or radicular distribution indicates a possible mononeuritis, entrapment neuropathy, or radiculopathy, and calls for a different workup than that required for a limb paresis in a patient with[aafp.org]
Slow Nerve Conduction Velocities
  • Case 58A A Woman with Leg Numbness Pain Weakness and Slow Nerve Conduction Velocities 372 Case 58B A Boy with Leg Weakness 375 Case 59 A Man with Hand Weakness and Numbness After Skiing 383 Case 60 A Man with Recurrent Foot Drop 386 Case 61 An Elderly[books.google.com]
Trichinella Spiralis
  • Trichinosis is caused by the nematode Trichinella spiralis . It is transmitted by ingestion of uncooked or poorly cooked pork or bear meat. Within 2 days of ingestion of the cysts, diarrhea, nausea, abdominal pain, and fever occur.[78stepshealth.us]
Right Bundle Branch Block
  • Electrocardiographic abnormalities, such as a prolonged PR interval, slurred QRS complex , ST-segment depression or elevation, and usually right bundle-branch block, are seen late in the disease.[78stepshealth.us]

Treatment

  • 200 9 Ankylosing Spondylitis C Treatment and Assessment 209 10 Reactive and Enteropathic Arthritis 217 11 Osteoarthritis A Clinical Features 224 11 Osteoarthritis B Pathology and Pathogenesis 229 11 Osteoarthritis C Treatment 235 12 Gout A Clinical Features[books.google.com]
  • Common clinical presentations of the endocrine myopathies are highlighted, along with diagnostic evaluation and treatments.[ncbi.nlm.nih.gov]
  • Treatments of steroid myopathy are as follows: Lower the dose of steroid, use a nonfluorinated glucocorticoid, and exercise or physical therapy.[ncbi.nlm.nih.gov]
  • Treatment of hypothyroidism is thyroid hormone replacement. With proper therapy, serum CK levels return to normal over several months. B. Thyrotoxic myopathy.[78stepshealth.us]
  • DM is humorally mediated whereas PM is cell mediated muscle injury Treatment with steroids, immuno suppresants and I.V immunoglobulins in PM and DM. 15 16 Endocrine myopathies Hyperthyroidism: Proximal weakness; periodic paralysis.[slideplayer.com]

Prognosis

  • Prognosis Prognosis is also very dependent of aetiology. E.g. congenital myopathies are chronic and progress over years, whereas other myopathies are more acute and can quickly lead to respiratory failure and other complications.[teesneuro.org]
  • Prognosis This depends on the specific diagnosis. The primary disorders are incurable conditions with varied prognosis. Secondary myopathy may be corrected by treating the underlying cause.[patient.info]
  • ; Scapular winging Fasciculations Rhabdomyolysis : With thyroid storm Bulbar syndrome: Dysphagia Tendon reflexes : Brisk Lab High T 3 or T 4 CK: Normal or low EMG: Myopathic; Fasciculations or fibrillations Muscle pathology: Normal or type 2 atrophy Prognosis[neuromuscular.wustl.edu]
  • Prognosis Prognosis is quite good. In two to four months after euthryoid state is achieved, muscle weakness improves. But it may take up to a year for muscle bulk to return. Respiratory failure is very rare.[encyclopedia.com]

Etiology

  • The etiologies of hyperadrenalism include pituitary or ectopic overproduction of adrenocorticotropic hormone (ACTH), adrenal tumors, or exogenous corticosteroid administration.[emedicine.medscape.com]
  • Inflammatory myopathies This group of myopathies is characterized by inflammation of unknown etiology within the muscles. A.[78stepshealth.us]
  • Myopathy is a common term for a muscle disease that is unrelated to any disorder of innervation or neuromuscular junction, with a wide range of possible etiologies.[news-medical.net]
  • Rhabdomyolysis may also be seen with infectious etiologies, alcohol, and toxic exposures.[clevelandclinicmeded.com]
  • Diagnosis begins with a patient history distinguishing weakness from fatigue or asthenia, separate conditions with different etiologies that can coexist with, or be confused for, weakness.[aafp.org]

Epidemiology

  • Pathology and Pathogenesis 319 15 Systemic Lupus Erythematosus C Treatment and Assessment 327 16 Antiphospholipid Syndrome 339 17 Systemic Sclerosis A Clinical Features 343 17 Systemic Sclerosis B Epidemiology Pathology and Pathogenesis 351 17 Systemic[books.google.com]
  • ., Wegener, HC, and Tauxe, RV Epidemiology of Campylobacter jejuni infections in the United States and other industrialized nations.[books.google.es]
  • Polymyalgia rheumatica (PMR) and temporal arteritis (TA): Although research is just beginning, Imrich and colleagues note that age-related changes in the neuroendocrine system could represent a pathogenic factor for PMR and/or TA in genetically disposed. [5] Epidemiology[emedicine.medscape.com]
  • Sensory-Motor neuropathy SPG 22 Ataxia May increase risk of: Statin myopathy External links eMedicine Hyperthyroidism Epidemiology Female Male Onset: Average 5th decade Myopathy (80%) Onset Slowly progressive; More common with increasing age Acute onset[neuromuscular.wustl.edu]
  • Epidemiology These are all relatively uncommon diseases: Duchenne muscular dystrophy is easily the most common childhood-onset muscular dystrophy and affects 1 in 3,300 boys. [ 6 ] The prevalence of Duchenne muscular dystrophy is 63 cases per million.[patient.info]
Sex distribution
Age distribution

Pathophysiology

  • This article discusses the clinical features, pathophysiology, and management of toxic and endocrine myopathies.[ncbi.nlm.nih.gov]
  • Get a quick and memorable overview of anatomy, pathophysiology, and clinical presentation from the precision and beauty of Netter and Netter-style plates that highlight key neuroanatomical and neurologic concepts.[books.google.com]
  • Mechanisms of Clinical Signs is the first consolidated text of its kind; designed to help medical students and junior doctors understand the pathophysiological mechanisms behind clinical signs.[books.google.com]
  • Steroid myopathy is the most common endocrine myopathy. [1] Pathophysiology Although abnormal endocrine states usually present with muscle weakness—most often proximal weakness—the exact pathophysiology remains incompletely understood.[emedicine.medscape.com]
  • Muscle and Neuromuscular Junction Disorders p. 1815-1828 December 2016, Vol.22, No.6 doi: 10.1212/CON.0000000000000407 REVIEW ARTICLES Article Related Links Abstract Purpose of Review: This article discusses the clinical features, pathophysiology, and[journals.lww.com]

Prevention

  • Early detection and expeditious correction of metabolic disturbances in endocrinopathies such as Cushing syndrome, thyroid and parathyroid diseases, and acromegaly can minimize and prevent neurologic complications including myopathy.[ncbi.nlm.nih.gov]
  • Recent Findings: Early detection and expeditious correction of metabolic disturbances in endocrinopathies such as Cushing syndrome, thyroid and parathyroid diseases, and acromegaly can minimize and prevent neurologic complications including myopathy.[journals.lww.com]
  • Physical therapists can help in devising muscle strengthening exercises and in preventing muscle contractures. Protective eye glasses and eye patches are used to prevent corneal exposure and ulceration.[encyclopedia.com]
  • Prevention Genetic counselling is, in some of the most common myopathies such as Duchenne muscular dystrophy, the only intervention that can prevent disease. In general: Give genetic counselling early.[patient.info]
  • Supportive therapy and physical therapy may prolong mobility and prevent contractures. F. Congenital myopathies are rare inherited diseases that begin during infancy. Progression may be quite insidious. Diagnosis rests on muscle biopsy. V.[78stepshealth.us]

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