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Rippling muscle syndrome preceding malignant lymphoma.

Akio Takagi1, Susumu Kojima, Tomoji Watanabe

  • 1Department of Neurology, Toranomon Hospital, Tokyo.

Internal Medicine (Tokyo, Japan)
|March 1, 2002
PubMed
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Rippling muscle syndrome, characterized by visible, propagating muscle contractions, may be linked to an underlying lymphoma. Treatment of the lymphoma resolved the muscle symptoms and normalized related biomarkers.

Area of Science:

  • Neurology
  • Oncology
  • Muscle Physiology

Background:

  • Rippling muscle phenomenon presents as uncomfortable muscular stiffness and visible, propagating muscle contractions upon percussion.
  • This rare condition, also known as myoedema, can be associated with various underlying pathologies.

Purpose of the Study:

  • To investigate a potential paraneoplastic or autoimmune link between rippling muscle syndrome and malignant lymphoma.
  • To explore the pathogenetic role of the skeletal muscle's internal membrane system.

Main Methods:

  • Case presentation of a 46-year-old woman with rippling muscle phenomenon.
  • Diagnostic workup including histological examination for lymphoma.
  • Therapeutic intervention with chemotherapy (vincristine, cyclophosphamide, doxorubicin, prednisolone) and monitoring of clinical symptoms and serum markers (IgG, creatine kinase).

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Main Results:

  • Malignant lymphoma (lymphoplasmacytoid lymphoma) was diagnosed three years after the onset of rippling muscle syndrome.
  • Treatment of lymphoma led to remission of the lymphoma, normalization of serum IgG and creatine kinase levels, and resolution of the rippling muscle phenomenon.
  • The patient's symptoms significantly improved with the lymphoma treatment.

Conclusions:

  • Rippling muscle syndrome in this case appeared to be paraneoplastic or autoimmune in origin, associated with an underlying lymphoma.
  • The internal membrane system of skeletal muscle may play a role in the pathogenesis of rippling muscle.
  • Effective treatment of the associated lymphoma can lead to remission of rippling muscle syndrome.