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[A case of myopathy with ulcerative colitis]
H Hasegawa1, K Hasegawa, T Saito
1Department of Internal Medicine, Kitasato University School of Medicine.
Rinsho Shinkeigaku = Clinical Neurology
|February 1, 1990
Summary
This study details a severe muscle weakness case in a patient with ulcerative colitis (UC), unresponsive to steroids. The findings suggest UC, not steroid myopathy, may induce these myopathic symptoms.
Area of Science:
- Neurology and Gastroenterology
- Investigating the neuromuscular complications of inflammatory bowel disease.
Background:
- Ulcerative colitis (UC) is an inflammatory bowel disease with known extraintestinal manifestations.
- Neuromuscular complications, though rare, can significantly impact patient morbidity.
Observation:
- A 41-year-old woman with ulcerative colitis presented with severe bloody diarrhea and rapidly progressing muscle weakness.
- Despite prednisolone treatment, the patient developed profound lower limb weakness, liver dysfunction, mild hyperthyroidism, and glucose intolerance.
- Muscle biopsy revealed type 1 and 2 fiber atrophy, myofibrillar degeneration, and nemaline bodies, distinct from typical steroid myopathy.
Findings:
- The patient exhibited laboratory and biopsy findings suggestive of a unique myopathy potentially linked to ulcerative colitis.
- Factors such as malnutrition, possible immunodeficiency, and hyperthyroidism were considered in the myopathy's pathogenesis.
- Improvement in muscle weakness postoperatively suggested a strong association with the underlying ulcerative colitis.
Implications:
- This case highlights a potential, albeit uncommon, neuromuscular complication of ulcerative colitis.
- The findings underscore the need to consider inflammatory bowel disease as a factor in unexplained myopathies.
- Further research is warranted to elucidate the mechanisms linking ulcerative colitis to myopathic changes.