Mitochondrial myopathy presenting as Rhabdomyolysis

David C. Patchett, Michael L. Grover

Research output: Contribution to journalArticle

3 Scopus citations

Abstract

A 37-year-old white woman presented with acute bilateral hamstring pain after hiking. She had a creatine kinase level of 11,144 U/L. Rhabdomyolysis was diagnosed and the patient was admitted for intravenous fluid hydration. The patient continued to have exercise-induced myalgias and elevations in her creatine kinase level. Rheumatologic causes were ruled out and results from electromyogram testing were nondiagnostic. A muscle biopsy revealed a mitochondrial myopathy. The 22 mitochondrial DNA and transfer RNA genes were sequenced. An A-to-G transition was found at nucleotide position 4281 in the transfer RNA isoleucine gene. The patient was placed on a regimen of riboflavin, vitamin C, and coenzyme Q10, which provided mild relief. The patient returned to the emergency department 2 more times after vigorous exercise, with creatine kinase levels as high as 2800 U/L. At last follow-up, the patient was using a fentanyl citrate transdermal patch, which enabled her to perform moderate exercise without pain.

Original languageEnglish (US)
Pages (from-to)404-405
Number of pages2
JournalJournal of the American Osteopathic Association
Volume111
Issue number6
StatePublished - Jun 1 2011

ASJC Scopus subject areas

  • Complementary and alternative medicine

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