Exertional myalgia syndrome associated with diminished serum ammonia elevation in ischemic exercise testing.

Abstract:

:A 36-year-old man with chronic severe exertional myalgias had a normal serum lactate elevation and diminished serum ammonia elevation on an ischemic forearm exercise test (IFET). The IFET is commonly performed in the evaluation of patients with complaints of exertional myalgias, cramps, and rhabdomyolysis. The finding of a normal serum lactate elevation and a diminished serum ammonia elevation after ischemic exercise is usually considered indicative of myoadenylate deaminase deficiency. However, myoadenylate deaminase activity was normal in this man's muscle biopsy specimen. This case suggests that a diminished serum ammonia elevation in the IFET is not always indicative of myoadenylate deaminase deficiency, a disorder of ammonia production. A diminished serum ammonia elevation in the IFET could also reflect an impairment of net ammonia efflux from muscle into blood.

journal_name

Mil Med

journal_title

Military medicine

authors

Riggs JE,Schochet SS Jr,Webb RW

keywords:

subject

Has Abstract

pub_date

1999-09-01 00:00:00

pages

663-5

issue

9

eissn

0026-4075

issn

1930-613X

journal_volume

164

pub_type

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