Vaingankar Abhishek, Garg Divyani, Agarwal Ayush, Radhakrishnan Divya M, Pandit Awadh Kishor, Tripathi Madhavi, Srivastava Achal K
Department of Neurology, All India Institute of Medical Sciences, New Delhi, India.
Department of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi, India.
Ann Indian Acad Neurol. 2024 Nov 1;27(6):724-726. doi: 10.4103/aian.aian_419_24. Epub 2024 Sep 9.
We report two cases of established Wilson's disease (WD) presenting with calcific myonecrosis of the pelvic girdle in association with pelvic fractures. Despite initial improvement with chelation, subacute worsening of ambulation in both led to a consideration of neurologic deterioration on chelation therapy. However, evaluation revealed calcific myonecrosis of the hip joint and adjacent muscles as the cause. Both patients improved with intensive rehabilitation. A review of literature indicates that although osseomuscular complications are reported in WD, calcific myonecrosis is a hitherto unknown entity which, if recognized early, may be reversed, preventing disability and unnecessary change in chelation regimens.
我们报告了两例确诊的威尔逊病(WD)病例,患者均出现骨盆带钙化性肌坏死并伴有骨盆骨折。尽管螯合治疗初期病情有所改善,但两人的步行能力均出现亚急性恶化,这使得人们考虑螯合治疗导致了神经功能恶化。然而,评估发现髋关节及邻近肌肉的钙化性肌坏死才是病因。两名患者经过强化康复治疗后均有改善。文献综述表明,尽管WD中报告了骨肌肉并发症,但钙化性肌坏死是一种迄今未知的情况,如果早期识别,可能会逆转,从而避免残疾和螯合治疗方案的不必要改变。