13 results
Creatine Kinase - Causes of Elevated CK Levels
Acute CK Elevation (Pain > Weakness):
 • RHABDOMYOLYSIS
Illness Myopathy ... - Inflammatory myopathy ... polymyositis, necrotizing myopathy ... - Autoimmune ... #differential #diagnosis
Autoimmune Myositis
Necrotizing myopathy is associated with higher CK levels, greater level of muscle weakness, less systemic
Autoimmune Myositis ... Necrotizing myopathy ... level of muscle weakness ... anti-synthetase syndrome ... and anti-HMGCR myopathy
Idiopathic Inflammatory Myopathies (IIM's)

RASH + MUSCLE WEAKNESS → Consider idiopathic inflammatory myopathies (IIM's)

 • Overlap Myositis
Any inflammatory myopathy ... antisynthetase syndrome ... Inflammatory myopathy ... #IIMs #diagnosis ... #dermatology #Myopathy
Statin Induced Muscle Toxicity - Summary

Clinical Presentation:
 • Elevations of serum creatine kinase with proximal myalgia
Toxicity - Summary Clinical ... proximal myalgia and weakness ... symmetric muscle weakness ... IU/I • SAMS clinical ... #diagnosis #management
Causes of Neuromuscular Weakness
 • Spinal Cord: Demyelinating Disease (MS), Epidural abscess, Infarction, Syringomyelia, Tetanus, Transverse
Neuromuscular Weakness ... Motor Nerves: ALS ... heavy metals), Critical ... Mitochondrial myopathy ... #differential #diagnosis
Weakness - Differential Diagnosis Framework

Approach To Weakness:
 • Non-neuromuscular disorder (Cardiac, pulmonary etc)
 • CNS ->
Diagnosis Framework ... Myopathy: ... mediated necrotizing myopathy ... • Autoimmune: ... #Differential #Diagnosis
Generalized Weakness - Differential Diagnosis Framework
"l feel weak":
 • Infectious: Influenza, EBV, PNA, Bacteremia, Sepsis
 •
Generalized Weakness ... - Differential Diagnosis ... I am weak": • Myopathy ... Rhabdomyolysis, Critical ... Polyneuropathy, ALS
Myositis Specific Antibodies (MSAs)

Dermatomyositis: MDA5, TIF1y, NXP2, Mi-2, SAE
Anti-Synthetase Syndrome: Jo-1, PL7, PL12, EJ, OJ
Immune Mediated
Anti-Synthetase Syndrome ... Mediated Necrotizing Myopathy ... Antibodies #MSAs #clinical ... #diagnosis #rheumatology ... #table
Autoimmune Myositis - Differential Diagnosis Framework

Inflammatory Myopathies: Commonly symmetric proximal muscle weakness, no substantial muscle pain
- Differential Diagnosis ... MYOPATHY: • Proximal ... • If myopathy ... ANTI-MITOCHONDRIAL MYOPATHY ... #Myositis #Myopathy
Ptosis - Differential Diagnosis Framework

Ptosis (Greek- to fall) Drooping of the upper eyelid that usually results
- Differential Diagnosis ... think about three clinical ... to ptosis and weakness ... Mitochondrial myopathy ... gravis • Ocular myopathy