Kim Koh-Woon, Cho Jae-Heung
Department of Korean Medicine Rehabilitation, College of Korean Medicine, Kyung Hee University, Seoul 02447, South Korea.
World J Clin Cases. 2021 Jul 16;9(20):5647-5654. doi: 10.12998/wjcc.v9.i20.5647.
In Behçet's disease (BD), very few cases of muscular involvement have been reported previously. The natural history and therapeutic protocol for muscular involvement in BD are obscure due to the low incidence of peripheral neuropathy or myopathy in BD. The purpose of our study was to report a rare case of BD with chronic, focal forms of neuromyopathy and review the relevant literature.
We herein report the case of a 54-year-old man who presented with progressive muscular atrophy and weakness of both thighs 2 years after the presentation of the cardinal symptoms of BD. The past medical history, electrophysiological study, neurological examination, blood tests, magnetic resonance imaging study, and histological exam were performed for the differential diagnosis. Relevant literature on muscular involvement in BD was reviewed. Neurological examination revealed that muscular involvement was predominantly localized in the proximal parts of the lower extremities. Heterogeneous enhancement of several thigh muscles was observed on magnetic resonance imaging, which corresponded with the clinical manifestations. Histological study of one of the enhanced muscles showed denervation atrophy of the muscle with superimposed myopathic changes, while electrophysiological studies only suggested denervation.
To our knowledge, this is the first case of neurogenic muscular atrophy with a specific set of clinical, radiological, electrophysiological, and histological findings reported in BD.
在白塞病(BD)中,此前报道的肌肉受累病例极少。由于BD中外周神经病变或肌病的发病率较低,BD中肌肉受累的自然病史和治疗方案尚不明确。我们研究的目的是报告1例罕见的伴有慢性局灶性神经肌肉病的BD病例,并复习相关文献。
我们在此报告1例54岁男性患者,在出现BD主要症状2年后,出现双侧大腿进行性肌肉萎缩和无力。为进行鉴别诊断,进行了既往病史、电生理检查、神经学检查、血液检查、磁共振成像检查和组织学检查。复习了关于BD肌肉受累的相关文献。神经学检查显示,肌肉受累主要局限于下肢近端。磁共振成像观察到多条大腿肌肉有不均匀强化,这与临床表现相符。对其中一条强化肌肉的组织学研究显示,肌肉有失神经萎缩并伴有叠加的肌病改变,而电生理检查仅提示失神经。
据我们所知,这是BD中报道的首例具有一组特定临床、放射学、电生理和组织学表现的神经源性肌肉萎缩病例。