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Inclusion body myositis: a case of bilateral extremity weakness.
[inclusion body myositis]
Inflammatory
myopathy
is
a
common
cause
of
bilateral
muscular
weakness
in
adults
.
Although
not
as
common
as
polymyositis
,
inclusion
body
myositis
(
IBM
)
is
a
form
of
inflammatory
myopathy
characterized
by
chronic
progressive
muscle
inflammation
and
often
goes
undiagnosed
and
untreated
.
IBM
patients
most
commonly
present
with
proximal
lower
extremity
weakness
and
may
have
normal
creatine
kinase
(
CK
)
levels
.
A
high
level
of
clinical
suspicion
is
required
for
prompt
and
accurate
diagnosis
of
IBM
,
which
is
diagnosed
definitively
with
a
muscle
biopsy
.
The
patient
described
in
this
case
report
is
a
68
-
year
-old
man
who
initially
presented
with
both
bilateral
symmetric
proximal
lower
extremity
and
distal
upper
extremity
weakness
.
IBM
was
suspected
through
history
,
electromyography
,
and
definitively
diagnosed
with
muscle
biopsy
.
The
patient
was
subsequently
initiated
on
prednisone
therapy
and
physical
therapy
,
with
improvement
in
muscular
strength
after
2
months
.
In
patients
presenting
with
bilateral
extremity
weakness
and
normal
CK
level
,
the
diagnosis
of
IBM
should
be
included
in
the
differential
diagnosis
and
muscle
biopsy
performed
for
appropriate
cases
.
Diseases
Validation
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"high level"
symptom
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aniridia
cadasil
carcinoma of the gallbladder
cohen syndrome
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erdheim-chester disease
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esophageal carcinoma
esophageal squamous cell carcinoma
familial hypocalciuric hypercalcemia
familial mediterranean fever
hodgkin lymphoma, classical
inclusion body myositis
liposarcoma
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omenn syndrome
oral submucous fibrosis
pyomyositis
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waldenström macroglobulinemia
well-differentiated liposarcoma
werner syndrome
x-linked adrenoleukodystrophy
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