Self-induced myopathy
| Autor: | S. J. S. Chataway, C. J. Mumford, James W. Ironside |
|---|---|
| Rok vydání: | 1997 |
| Předmět: |
medicine.medical_specialty
Supine position Hypokalemia Candy chemistry.chemical_compound Muscular Diseases Internal medicine medicine Glycyrrhiza Humans Bendroflumethiazide Myopathy Antihypertensive Agents Creatinine Plants Medicinal biology business.industry Myoglobinuria General Medicine Middle Aged medicine.disease Blood pressure Endocrinology chemistry Anesthesia biology.protein Creatine kinase Female medicine.symptom business medicine.drug Research Article |
| Zdroj: | Postgraduate medical journal. 73(863) |
| ISSN: | 0032-5473 |
| Popis: | Accepted 27 November 1996 A 55-year-old woman was admitted with a two-day history of progressive weakness in her arms and legs associated with a diffuse muscle ache. She had been completely well until four days prior to presentation when she had noticed tingling in her fingers. This spread to her arms over the following 24h and she then developed progressive weakness in all four limbs. On the day of admission she was unable to get out of bed or to lift her arms above her head. There were no systemic, visual or bulbar symptoms and sphincter function was normal. Her medical history included controlled mild hypertension, osteoarthritis, depression and negative investigations for postmenopausal bleeding. At the time of admission she was taking sertraline 100mg od, lisinopril 50mg od, dihydrocodeine 60mg bid and ibuprofen slow release. Bendrofluazide 2.5 mg od had recently been introduced. Neurological examination showed normal cognitive and cranial nerve function. There was marked weakness of neck flexion and an asymmetric flaccid quadraparesis, most marked proximally and on the right. She was unable to raise her arms above 90° nor to lift her legs against gravity. The quadriceps muscles were painful on palpation and limb reflexes were present only with reinforcement. Co-ordination and sensation were normal. On general examination the blood pressure was 180/100mmHg supine with no postural drop. The remainder of the examination was unremarkable. Laboratory investigations revealed the following: serum sodium 143 mmol/l, potassium 2.0 mmol/l, urea 5.3 mmol/l, glucose 5.9 mmol/l, alanine aminotransferase 144 U/l, bilirubin 50 jumol/l, alkaline phosphatase 113 U/l, phosphate 0.73 mmol/l, calcium 2.36 mmol/l, magnesium 0.84mmol/l, albumin 39g/l, creatinine 83,umol/l, creatine kinase elevated at 2629IU/l (normal range 24-161 IU/l, CK-MB 23 1U/l (normal)). Thyroxine, thyroid-stimulating hormone, B12, folate, and full blood count were all normal. A 12-lead echocardiogram was normal including T-wave morphology. Urinalysis showed no evidence of myoglobinuria. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|