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Neuromuscular 03

Topic: Pathology

Created on Sunday, February 8 2009 by gliageek

Last modified on Sunday, February 8 2009.

Courtesy of Dr. Mark Cohen

This 42-year old former all-American quarterback comes in complaining of slowly progressive lower extremity weakness which began just after he got married 15 years ago. Which of the following diagnoses is most likely correct?

A) Polymyositis

B) Dermatomyositis

C) Inclusion body myositis

D) Dysferlinopathy

E) FSH dystrophy

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This question was created on February 08, 2009 by gliageek.
This question was last modified on February 08, 2009.

ANSWERS AND EXPLANATIONS

A) polymyositis

This answer is incorrect.

PM shows invasion of muscle fibers, and a more rapid course (See References)


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B) dermatomyositis

This answer is incorrect.

Though the distribution of inflammation is OK, the infiltrate in DM is composed of a mixture of lymphocytes, plasma cells, and occasional eosinophils. (See References)


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C) inclusion body myositis

This answer is incorrect.

42 is just way too young for this (especially with onset in the 20s (See References)


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D) Dysferlinopathy

This answer is correct.

Dysferlin is responsible for repairing membrane defects, and dysferlinopathy usually presents in early adulthood. The presence of inflammation may mislead one into a diagnosis of inflammatory myopathy (See References)


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E) FSH dystrophy

This answer is incorrect.

FSH dystrophy may be accompanied by inflammation, but shows a different pattern of weakness (See References)


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References:

1. Prayson, R.A., and Goldblum, J.R. (Eds.) (2005). Neuropathology. Elsevier Churchill Livingstone, Philadelphia. (ISBN:0443066582)

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pathology
Neuromuscular 03
Question ID: 020809073
Question written by gliageek. (C) FrontalCortex.com 2006-2009, all rights reserved. Created: 02/08/2009
Modified: 02/08/2009
Estimated Permutations: 120