Myositis associated graft-versus-host-disease presenting as respiratory muscle weakness.
Myositis associated with graft-versus-host-disease (GVHD) typically presents with proximal muscle weakness, myalgias, and a raised creatinine phosphokinase (CPK) level. We report a case of a 51 year old man who developed respiratory muscle weakness five years after an allogeneic bone marrow transplant for multiple myeloma. His symptoms included tachypnoea, abdominal paradox, and orthopnoea. Pulmonary function tests revealed diminished vital capacity and maximal inspiratory and expiratory pressures. Serum CPK levels were raised and a peripheral muscle biopsy specimen was consistent with GVHD. He improved with immunosuppressive therapy.
Stephenson
A L
AL
Department of Respirology, Department of Pathology, Vancouver General Hospital & Health Sciences Centre, The University of British Columbia, 2775 Heather Street, Vancouver, BC, V5Z 3J5 Canada.
Mackenzie
I R
IR
Levy
R D
RD
Road
J
J
D016026:Bone Marrow Transplantation / Q000009:adverse effects*; D003404:Creatinine / Q000097:blood; D005541:Forced Expiratory Volume / Q000502:physiology; D006086:Graft vs Host Disease / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000628:therapy; D009220:Myositis / Q000209:etiology*; D012132:Respiratory Muscles; D014797:Vital Capacity / Q000502:physiology
D003404:Creatinine