The patient refers to muscle weakness. Mention some common muscular diseases, an
ID: 305617 • Letter: T
Question
The patient refers to muscle weakness. Mention some common muscular diseases, and explain them briefly, including their prognoses.
Personal Information
Name: Mr. Elliot Bryan
Age: 29 years old
Gender: Male
Description
Mr. Bryan is a 29-year-old married man who came to the medical office because, over the last three years, he has progressively increased the size of his shoes, and he has resized his wedding ring three times. He says his feet and hands have grown. He has also noticed that his face has turned coarse. He was a very active man and practiced sports, but now he fatigues just by walking, and feels weakness in his muscles and stiffness in his joints. He is depressed because in the last few months he has been experiencing erectile dysfunction, which is affecting his relationship with his wife. He feels he is losing his vision as well.
Mr. Bryan does not drink alcohol, smoke, or use any recreational drug. His mother suffers from diabetes mellitus type II, and his father suffers from hypertension.
On physical examination we found:
Remarkable Signs on Physical Exam by Regions
Head: Enlarged and coarsened facial features, prominent superciliary arches, prognathism
Neck: Thyroid is visible and palpable
Thorax: Barrel appearance
Abdomen: Hepatomegaly. Splenomegaly.
SOMA: Enlargement of the hands and feet. Generalized arthralgia.
Remarkable Signs on Physical Exam by Systems
Integumentary system: Thick and oily skin. Numerous acrochorda disseminated throughout the body.
Cardiovascular system: Blood pressure 150/100. Radial pulse 72.
Digestive system: Megaloglossia. Diastema.
Lab Tests
Complete blood count (CBC)
GH measurement
IGF-I measurement
Growth hormone suppression test
Glucose level
Brain MRI
Abdominal CT scan
Echocardiogram
Diagnosis
Acromegaly
Explanation / Answer
Muscular diseases are the diseases which affects the muscular system of our body. It affects all age groups and cause physical disability. They are of different types which require different treatment regimin and have different prognosis.
Types of muscular disease are :-
Genetic - These are caused due to gene disorder. Examples are muscle dystrophy, myopathies etc.
Non -genetic - Non genetic means the muscle diseases which are not genetic .Most common example is inflammatory muscle disease in which immune system injures body's own muscles .Example myasthenia gravis.
Common muscular diseases are:-
1. Muscle dystrophy- characterized by progressive weakness and wasting of skeleton or voluntary muscles. These are genetic type of muscular disease.In this there is progressive degradation of muscle fibers,changes in muscle sizes , phagocytosis and replacement of muscle by connective tissue.
Patient complain of fatigue muscle weakness affects depend upon the part involved like if gastrointestinal tract in involved then the patient complain of constipation,fecal impaction,gastric dilation , respiratory difficulty if lungs are involved , difficulty in walking , running if muscles of the legs are involved.
The prognosis of disease depends on the part which is affected and the type of dystrophy . It causes weaknesses ,wasting ,myotonia and muscle stiffness.The treatment is supportive care and prevention of complications.
2. Myasthenia gravis -is a auto immune disorder myoneural junction. In this the antibodies attack the acetylcholine receptor site causing impaired transmission of impulses resulting in voluntary muscle weakness.
The initial manifestation starts from eyes -diplopia and ptosis ,then affecting face causing numb faceial expression then to throat difficulty in swallowing, difficulty in speaking, risk of aspiration , respiratory difficulty etc.
The prognosis of myasthenia gravis is good due to the advance treatment modalities like plasmapheresis, immunosuppressive therapy,use of corticosteroid .The first line therapy is pyrodstigmine bromide.
3.Myopathy - disease condition in which muscles don't function properly .It causes muscle weakness, stiffness,tetany, cramps.
The treatment of myopathy is cause targeting therapy which may be physical,drug,or surgerical therphy.
If the cause of myopathies are treated successfully then the prognosis is good.
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