Myopathic charges in bilharzial hepatosplenomegaly; clinical and histopathological studies

ABSTRACT

We studied neuromuscular changes in 35 patients suffering from bilharzial hepatosplenomegaly. Bilateral symmetrical weakness and wasting in the shoulder girdle muscles were detected in 28 patients. The severest degree of muscle wasting was present in 6 patients presenting with massive ascites. The level of serum albumin was below 3 gm% and there was history of repeated abdominal tapping for ascites in 2 patients. Muscle biopsy was studied in patients with moderate and severe muscle wasting. The study revealed definite myopathic changes in 7 patients with marked variation in the size of muscle fibres, degenerative changes with loss of transverse striations. The subsarcolemmal nuclei were definitely increased in number and size and became centrally migrated in hyalinosed muscle fibres. There was an increase in the amount of fibrous and fatty tissues between the muscle fibres. Trichrome and myophosphrylase stains showed type I fibres predominating type II fibres which favour myopathic changes