Amyloid myopathy presenting with rhabdomyolysis: evidence of complement activation.
At age of 57 years, a man experienced an episode of rhabdomyolysis. On that occasion muscle biopsy was not performed, however monoclonal gammopathy of undetermined significance (MGUS) was diagnosed. Further he developed a moderate proximal muscle weakness with CK level persistently elevated (1000-1200U/l). When he came to our observation, at age 67, a muscle biopsy revealed an amyloid myopathy and multiple myeloma was at the same time disclosed. Terminal complement complex C5b9 (membrane attack complex) deposits were found in the vessel walls and muscle fibers surface depicted by amyloid. Our case suggests to keep in mind the possibility that amyloid myopathy may begin as an isolate episode of rhabdomyolysis. The detection of complement complex C5b9 suggests that complement cascade is implicated in the muscular damage of amyloid myopathy.
Rodolico
C
C
Department of Neurosciences, Psychiatry and Anaesthesiology, University of Messina, Messina, Italy. crodolico@unime.it
Mazzeo
A
A
Toscano
A
A
Pastura
C
C
Maimone
D
D
Musumeci
O
O
Musolino
C
C
Vita
G
G
D000368:Aged; D000686:Amyloidosis / Q000175:diagnosis / Q000276:immunology* / Q000503:physiopathology; D001623:Betamethasone / Q000627:therapeutic use; D001706:Biopsy; D001808:Blood Vessels / Q000378:metabolism / Q000473:pathology; D015938:Complement Membrane Attack Complex / Q000276:immunology / Q000378:metabolism; D003165:Complement System Proteins / Q000276:immunology* / Q000378:metabolism; D003402:Creatine Kinase / Q000097:blood; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008558:Melphalan / Q000627:therapeutic use; D018908:Muscle Weakness / Q000175:diagnosis / Q000503:physiopathology; D018482:Muscle, Skeletal / Q000276:immunology* / Q000473:pathology / Q000503:physiopathology; D009135:Muscular Diseases / Q000175:diagnosis / Q000276:immunology* / Q000503:physiopathology; D019653:Myeloablative Agonists / Q000627:therapeutic use; D012206:Rhabdomyolysis / Q000175:diagnosis / Q000276:immunology* / Q000503:physiopathology; D016896:Treatment Outcome
D015938:Complement Membrane Attack Complex; D005938:Glucocorticoids; D019653:Myeloablative Agonists; D003165:Complement System Proteins; D001623:Betamethasone; D003402:Creatine Kinase; D008558:Melphalan