Adult-onset nemaline myopathy and monoclonal gammopathy: a case report.

Abstract:

:A 47-year-old female developed proximal limb weakness after hysterectomy for uterine fibromatosis. Muscle strength slowly improved, but relapse occurred at age 52. She presented with progressive gait difficulty, proximal limb weakness, and painful calves. Family history was not contributory. Cranial nerves, deep tendon reflexes, and sensation were normal. Serum creatine kinase was normal. An IgG kappa monoclonal protein was found. Nerve conduction studies were normal, but EMG showed brief small polyphasic motor unit action potentials with early recruitment in proximal muscles. Muscle biopsy showed abundant rods, atrophic muscle fibres, and type 1 fibre predominance. The sarcolemma was immunoreactive for IgG kappa. Plasmapheresis was unsuccessful, but methylprednisolone and azathioprine led to moderate improvement of muscle strength, associated with reduced monoclonal protein levels. This is the third case report, describing the association of monoclonal gammopathy and late-onset nemaline myopathy. Presence of a monoclonal protein at the sarcolemma and responsiveness to immunosuppressive treatment are suggestive of a dys-immune origin.

journal_name

Acta Neurol Belg

journal_title

Acta neurologica Belgica

authors

Deconinck N,Laterre EC,Van den Bergh PY

keywords:

subject

Has Abstract

pub_date

2000-03-01 00:00:00

pages

34-40

issue

1

eissn

0300-9009

issn

2240-2993

journal_volume

100

pub_type

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