Myopathy B 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