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Non-alcoholic Wernicke's encephalopathy: toxic ingestion or an honest mis-steak?

A 21-year-old male presented with a 2-week history of nausea and non-bloody, non-bilious vomiting, accompanied by diffuse chronic myalgia. The patient endorsed headaches, dizziness, and diplopia that had started one day prior to admission. The patient had consumed a meat-only diet for the prior year. The patient was found to have a high anion gap metabolic acidosis with a superimposed normal anion gap metabolic acidosis in the setting of a several-month history of ingesting multiple naturopathic substances as well as recent use of disulfiram for management of his chronic myalgia. Magnetic reso…

[Muscular Sarcoidosis].

Muscular sarcoidosis is a granulomatous myopathy of unknown etiology characterized by the presence of non-caseating granulomas associated with sarcoidosis. Asymptomatic muscle involvement is revealed by imaging findings in majority of the patients with muscular sarcoidosis. Symptomatic muscular sarcoidosis, namely sarcoid myopathy, is a rare condition, and three distinct clinical types are recognized: nodular myopathy, acute myopathy, and chronic myopathy. Patients often present with myalgia, progressive weakness, and atrophy of the proximal muscles of the extremities. In order to confirm a di…

Prevalence of bruxism and temporomandibular disorders among orphans in southeast Uganda: A gender and age comparison.

OBJECTIVES: The aims of the current study were: (1) to assess the prevalence of oral habits, bruxism, and temporomandibular disorders (TMDs) … erformed by 93% of the participants. When performed extensively, they were significantly related to myalgia. No gender or age significant differences were found. CONCLUSIONS: 1. Only extensive masticatory parafunctional oral activity is significantly related to myalgia. 2. Gender and age had no impact on the prevalence of bruxism, oral habits, or TMDs. 3 …

Neurological manifestations of Chikungunya and Zika infections.

The epidemics of Chikungunya virus (CHIKV) and Zika virus (ZIKV) infections have been considered the most important epidemiological occurrences in the Americas. The clinical picture of CHIKV infection is characterized by high fever, exanthema, myalgia, headaches, and arthralgia. Besides the typical clinical picture of CHIKV, atypical manifestations of neurological complications have been reported: meningo-encephalitis, meningoencephalo-myeloradiculitis, myeloradiculitis, myelitis, myeloneuropathy, Guillain-Barré syndrome and others. The diagnosis is based on clinical, epidemiological, and labo…

MEFV gene polymorphisms and TNFRSF1A mutation in patients with inflammatory myopathy with abundant macrophages.

Inflammatory myopathy with abundant macrophages (IMAM) has recently been proposed as a new clinical condition. Although IMAM shares certain similarities with other inflammatory myopathies, the mechanisms responsible for this condition remain unknown. Patients with familial Mediterranean fever (FMF) and tumour necrosis factor receptor-associated periodic syndrome (TRAPS) also often develop myalgia. We therefore investigated the polymorphisms or mutations of MEFV and TNFRSF1A genes in patients with IMAM to identify their potential role in this condition. We analysed the clinical features of nine…

Non-infectious myositis of the lateral pterygoid muscle: a report of four cases.

Non-infectious myositis is a condition characterized by chronic localized myalgia originating from central nervous system effects. It is also known as centrally mediated myalgia associated with neurogenic inflammation. When this condition occurs in the lateral pterygoid muscle, clinical evaluation is difficult due to its inaccessible anatomic location. In order to diagnose this rare condition, careful clinical examination and advanced imaging are necessary. The authors report herein four cases of non-infectious myositis of the lateral pterygoid muscle diagnosed by magnetic resonance or enhance…

[McArdle disease presenting with rhabdomyolisis and acute kidney injury].

McArdle disease typically presents in childhood or young adults with myalgia, exercise intolerance, cramps and myoglobinuria. Deficiency of myophosphorylase enzyme results in inability to degrade glycogen stores, causing glycogen accumulation in muscle tissue and energy deficit. Evolution with rhabdomiolysis may occur and can be complicated with acute kidney injury but rarely, in about 11% of cases, is the initial disease manifestation. We report a case of McArdle Disease in a 38-year-old male patient. The disease went unrecognized despite previous symptoms (myalgia, exercise intolerance and s…

Statin myotoxicity: a review of genetic susceptibility factors.

The 3-hydroxy-3-methylglutaryl coenzyme A (HMGCoA) reductase inhibitors (statins) are among the most common medications prescribed worldwide, but their efficacy and toxicity vary between individuals. One of the major factors contributing to intolerance and non-compliance are the muscle side-effects, which range from mild myalgia through to severe life-threatening rhabdomyolysis. One way to address this is pharmacogenomic screening, which aims to individualize therapy to maximize efficacy whilst avoiding toxicity. Genes encoding proteins involved in the metabolism of statins as well as genes kn…

Case of streptococcal toxic shock syndrome caused by rapidly progressive group A hemolytic streptococcal infection during postoperative chemotherapy for cervical cancer.

Streptococcal toxic shock syndrome (STSS) is a severe infectious disease caused by group A hemolytic streptococcus (Streptococcus pyogenes). This condition is a serious disease that involves rapidly progressive septic shock. We experienced a case of STSS caused by primary peritonitis during treatment with paclitaxel and cisplatin (TP therapy) as postoperative chemotherapy for cervical cancer. STSS mostly develops after extremity pain, but initial influenza-like symptoms of fever, chill, myalgia and gastrointestinal symptoms may also occur. TP therapy is used to treat many cancers, including gy…

Exercise training and work task induced metabolic and stress-related mRNA and protein responses in myalgic muscles.

The aim was to assess mRNA and/or protein levels of heat shock proteins, cytokines, growth regulating, and metabolic proteins in myalgic muscle at rest and in response to work tasks and prolonged exercise training. A randomized controlled trial included 28 females with trapezius myalgia and 16 healthy controls. Those with myalgia performed ~7 hrs repetitive stressful work and were subsequently randomized to 10 weeks of specific strength training, general fitness training, or reference intervention. Muscles biopsies were taken from the trapezius muscle at baseline, after work and after 10 weeks…

Myopathy with hexagonally cross-linked crystalloid inclusions: delineation of a clinico-pathological entity.

A novel myopathy characterized by hexagonally cross-linked tubular arrays has been reported in five patients. We studied the clinical and histopathological features of five additional unrelated patients with this myopathy. Patients experienced exercise intolerance with exercise-induced myalgia and weakness, without rhabdomyolysis. One patient additionally presented mild permanent pelvic girdle muscle weakness. Age at onset varied between 13 and 56 years. The inclusions were eosinophilic on H and E, bright red with modified Gomori's trichrome stains, present in type 2 fibers, and revealed immun…

Activity of certain drugs in inducing of inflammatory myopathies with cutaneous manifestations.

BACKGROUND: At present, the pharmacological activity of drugs in inducing of inflammatory myopathies is not a solved problem. OBJECTIVE: Analysis of the adverse reaction of drugs show that in both adults and children they can cause clinical manifestations of dermatomyositis and its variants [classic, juvenile, paraneoplastic or amyopathic], polymyositis and its variants [eosinophilic myositis, overalp syndrome], or other conditions such as eosinophilia myalgia syndrome, and eosinophilic fasciitis. METHODS: Literature databases were analyzed and combined with personal experience to identify d…

Primary carnitine deficiency: adult onset lipid storage myopathy with a mild clinical course.

We studied two adult patients with myalgia and muscular fatigability during prolonged physical exercise. Serum creatine kinase was increased and muscle biopsy revealed a lipid storage myopathy affecting predominantly the type I fibres. Skeletal muscle carnitine content was reduced to 15% and 21% of the normal mean values, while serum carnitine levels were either normal or decreased. Four months of oral therapy with L-carnitine (3 g per day) resolved the clinical symptoms completely in both patients, and a subsequent muscle biopsy confirmed a marked reduction of lipid storage, along with increa…

[The association of polyarteritis nodosa and familial Mediterranean fever].

INTRODUCTION: Some necrotizing vasculitis may be associated with familial Mediterranean fever (FMF). We report a new case of polyarteritis nodosa (PAN) that preceded the diagnosis of FMF. OBSERVATION: A young woman of Turkish origin had a long childhood history of inflammatory arthralgia and myalgia, leading to the provisional diagnosis of chronic juvenile arthritis, then, after a confirmative muscle biopsy, to the diagnosis of PAN, whose outcome remained benign. At the age of 19, she was diagnosed as having FMF on clinical and genetic grounds, and colchicine led to the regression of most sym…

Chronic meningococcemia.

A case is reported of a 70-year-old woman with chronic meningococcemia. She had intermittent fever, purpuric papules disseminated on the trunk and limbs, headache, arthralgia and myalgia for 5 weeks. Treatment with ceftriaxone was rapidly successful.

Энтеровиральная этиология некоторых эпидемических вспышек в зоне Румынии.

Авторы описывают три эпидемии энтеровируса: вспышку эпидемии миальгии Коксаки В1, эпидемию эховируса 4 и эпидемическую рвоту и диарею, вызванную вирусом Коксаки А9. Этиологический диагноз был установлен с помощью вирологических и серологических тестов.

Совпадение в аннотации оригинала
The authors describe three enterovirus epidemics: an outbreak of Coxsackie B1 epidemic myalgia, one of echovirus 4 meningitis and one of epidemic vomiting and diarrhea caused by Coxsackie A9 virus. Etiological diagnosis was established by virological and serological tests.

Neuromuscular Disorders Associated With COVID-19.

The coronavirus disease 2019 (COVID-19) pandemic has had an enormous impact on practically every aspect of daily life, and those with neuromuscular disorders have certainly not been spared. The effects of COVID-19 infection are far-reaching, going well beyond respiratory symptoms alone. From simple myalgias to debilitating critical illness neuromyopathies, we continue to learn and catalog the diverse pathologies presented by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) as it relates to the neuromuscular system. Complications have been documented both as a direct result of p…

A Rare Case of Rhabdomyolysis.

Rhabdomyolysis is a pathological condition presenting with symptoms of localized or generalized myalgia and weakness, associated with an increase in serum creatine kinase level and, often leading to myoglobinuria and acute kidney injury. It has a wide range of etiologies. Immune-mediated necrotizing myopathy (IMNM) is a rare type of inflammatory myopathy, that leads to rhabdomyolysis, and it is divided into three different subtypes: anti-3-hydroxy-3-methylglutaryl-coA reductase (anti-HMGCR, anti-signal recognition particle (anti-SRP), and seronegative. There are slight differences in incidence…

[Features of 164 SARS-CoV-2 (+) patients consulting at an emergency room].

BACKGROUND: The clinical manifestations, mortality rates, laboratory and imaging findings of SARS-CoV-2 infection are not yet fully elucidat … he most common presenting symptom was dry cough in 47% of patients, followed by headache in 42% and myalgias in 42%. Forty five percent referred contact with an infected patient or having travelled out of town. Thirty-three (20%) required hospital admission and 5% required admission to an intensive care unit. CONCLUSIONS: These patients were predominantl …

[Evaluation of the diagnostic test for rapid detection of covid-19 antigen (Panbio Covid rapid test) in primary care].

OBJECTIVE: COVID-19 infection requires early diagnosis, with PCR being the gold standard test. The protocols advocate the use of rapid antig … ariate analysis, there was no relationship between symptoms and the presence of disease, except for myalgias (p=0.030). The multivariate analysis found a relationship between cough, dyspnea, fever, myalgia, anosmia/ageusia, and ocular symptoms and the presence of disease. CONCLUSIONS: The sensitivity and specificity for the Panbio rapid antigen test are …