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Neurol India ; 70(3): 1235-1237, 2022.
Article in English | MEDLINE | ID: mdl-35864676

ABSTRACT

Myopathies associated with systemic diseases results from several different disease processes. Myopathy as the initial presenting symptom in Crohn's disease is a rare presentation. We report a 20-yearr-old lady who presented with a painful proximal myopathy. On examination, she was malnourished with pallor, angular cheilitis, Bitots spots, and bilateral pitting pedal edema. Laboratory evaluation showed iron deficiency anemia, hypoalbuminemia, and very low vitamin D levels with elevated creatine phosphokinase levels. A possibility of osteomalacic metabolic myopathy due to vitamin D deficiency was considered. The malabsorption workup was negative. A colonoscopic biopsy showed noncaseating granulomatous inflammation suggestive of Crohn's disease. With supplementary therapy and specific treatment, she was asymptomatic at 6-months follow-up with no residual neurological deficits. A detailed history and an algorithmic approach will be very useful in making the differential diagnosis in any patient presenting with muscle weakness in myopathy associated with systemic illness.


Subject(s)
Crohn Disease , Metabolism, Inborn Errors , Muscular Diseases , Vitamin D Deficiency , Crohn Disease/complications , Crohn Disease/diagnosis , Diagnosis, Differential , Female , Granuloma/diagnosis , Humans , Metabolism, Inborn Errors/diagnosis , Muscular Diseases/complications , Muscular Diseases/etiology
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