A 68-year-old man is evaluated for a 1-year history of progressive fatigue, mild dyspnea on exertion, difficulty ambulating, and generalized weakness. He now has difficulty getting out of a chair. He reports no joint or muscle pain. He also has a 15-year history of hypercholesterolemia previously treated with lovastatin, which was discontinued 4 months ago because of his muscle weakness. On physical examination, temperature is 36.8 °C (98.2 °F), blood pressure is 142/84 mm Hg, pulse rate is 82/min, and respiration rate is 18/min. There is no rash or lymphadenopathy. Cardiac examination is normal. The lungs are clear. Sensation and reflexes are normal. Muscle strength in the quadriceps and wrists is decreased. Hand grip strength is decreased, most notably in the right hand. Laboratory studies: Erythrocyte sedimentation rate -32 mm/h Creatine kinase- 430 units/L Serum creatinine- Normal Antinuclear antibodies -Negative Which of the following is the most likely diagnosis? A)Dermatomyositis B)Inclusion body myositis C)Polymyositis D)Statin-induced myopathy
Posted on: Tue, 13 Jan 2015 22:04:00 +0000
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