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Metabolic neuropathies and myopathies.
[adrenomyeloneuropathy]
Inborn
errors
of
metabolism
may
impact
on
muscle
and
peripheral
nerve
.
Abnormalities
involve
mitochondria
and
other
subcellular
organelles
such
as
peroxisomes
and
lysosomes
related
to
the
turnover
and
recycling
of
cellular
compartments
.
Treatable
causes
are
β-oxidation
defects
producing
progressive
neuropathy
;
pyruvate
dehydrogenase
deficiency
,
porphyria
,
or
vitamin
B
12
deficiency
causing
recurrent
episodes
of
neuropathy
or
acute
motor
deficit
mimicking
Guillain-
Barré
syndrome
.
On
the
other
hand
,
lysosomal
(
mucopolysaccharidosis
,
Gaucher
and
Fabry
diseases
)
,
mitochondriopathic
(
mitochondrial
or
nuclear
mutations
or
mDNA
depletion
)
,
peroxisomal
(
adrenomyeloneuropathy
,
Refsum
disease
,
sterol
carrier
protein-
2
deficiency
,
cerebrotendinous
xanthomatosis
,
α-methylacyl
racemase
deficiency
)
diseases
are
multisystemic
disorders
involving
also
the
heart
,
liver
,
brain
,
retina
,
and
kidney
.
Pathophysiology
of
most
metabolic
myopathies
is
related
to
the
impairment
of
energy
production
or
to
abnormal
production
of
reactive
oxygen
species
(
ROS
)
.
Main
symptoms
are
exercise
intolerance
with
myalgias
,
cramps
and
recurrent
myoglobinuria
or
limb
weakness
associated
with
elevation
of
serum
creatine
kinase
.
Carnitine
palmitoyl
transferase
deficiency
,
followed
by
acid
maltase
deficiency
,
and
lipin
deficiency
,
are
the
most
common
cause
of
isolated
rhabdomyolysis
.
Metabolic
myopathies
are
frequently
associated
to
extra
-neuromuscular
disorders
particularly
involving
the
heart
,
liver
,
brain
,
retina
,
skin
,
and
kidney
.
Diseases
Validation
Diseases presenting
"rhabdomyolysis"
symptom
adrenomyeloneuropathy
dystrophic epidermolysis bullosa
focal myositis
inclusion body myositis
pyomyositis
pyruvate dehydrogenase deficiency
scrub typhus
systemic capillary leak syndrome
This symptom has already been validated