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Myopathy B9402040 許許許

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Page 1: Myopathy B9402040 許瑜真. Myopathy Inflammatory disorders Endocrine disorders Electrolyte disorders Metabolic myopathies Drugs and toxins Infections Rhabdomyolysis

Myopathy

B9402040 許瑜真

Page 2: Myopathy B9402040 許瑜真. Myopathy Inflammatory disorders Endocrine disorders Electrolyte disorders Metabolic myopathies Drugs and toxins Infections Rhabdomyolysis

Myopathy

• Inflammatory disorders• Endocrine disorders• Electrolyte disorders• Metabolic myopathies• Drugs and toxins• Infections • Rhabdomyolysis

Page 3: Myopathy B9402040 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]

Page 4: Myopathy B9402040 許瑜真. Myopathy Inflammatory disorders Endocrine disorders Electrolyte disorders Metabolic myopathies Drugs and toxins Infections Rhabdomyolysis

Endocrinopathy (Endocrine disorders)

• Hypothyroidism• Cushing's syndrome (or exogenous steroid

administration)

Page 5: Myopathy B9402040 許瑜真. Myopathy Inflammatory disorders Endocrine disorders Electrolyte disorders Metabolic myopathies Drugs and toxins Infections Rhabdomyolysis

Electrolyte disorders

• Hypokalemia• Hypophosphatemia• Hypocalcemia• Hypernatremia or hyponatremia

Page 6: Myopathy B9402040 許瑜真. Myopathy Inflammatory disorders Endocrine disorders Electrolyte disorders Metabolic myopathies Drugs and toxins Infections Rhabdomyolysis

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

Page 7: Myopathy B9402040 許瑜真. Myopathy Inflammatory disorders Endocrine disorders Electrolyte disorders Metabolic myopathies Drugs and toxins Infections Rhabdomyolysis

Drug-induced myopathy

• Medication, alcohol, or substance-abuse

Page 8: Myopathy B9402040 許瑜真. Myopathy Inflammatory disorders Endocrine disorders Electrolyte disorders Metabolic myopathies Drugs and toxins Infections Rhabdomyolysis

Infections

• Viral– influenza, parainfluenza, Coxsachie, HIV,

cytomegalovirus, echovirus, adenovirus, Epstein Barr virus

• Bacterial– pyomyositis, lyme myositis

• Fungal• Parasitic– trichinosis, toxoplasmosis

Page 9: Myopathy B9402040 許瑜真. Myopathy Inflammatory disorders Endocrine disorders Electrolyte disorders Metabolic myopathies Drugs and toxins Infections Rhabdomyolysis

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