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[Pseudo-myasthenic myopathy in a woman with anorexia nervosa].

Rev Med Interne

November 2007

Service de médecine interne, immunologique clinique, hôpital Jean-Minjoz, CHU de Besançon, 2, boulevard Fleming, 25030 Besançon cedex, France.

Skeletal myopathy, although foreseeable in severe malnutrition, has been rarely reported in patients with anorexia nervosa. We report a case of oculo-oropharyngeal myopathy mimicking myasthenia in a 42-year-old woman with an history of anorexia nervosa, completely reversible after refeeding with carbohydrate diet, mainly chocolate. Nutritional myopathies are not well known and therefore rarely looked for in patients with anorexia nervosa.

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A 32-year-old, HIV-positive homosexual with Kaposi's sarcoma was given subcutaneous interferon-A (IFN) for two- and a-half months. The patient complained of ocular symptoms (ptosis of the left eyelid and intermittent diplopia) after the application of IFN-A. These symptoms persisted for the period of treatment and subsided after therapy was stopped.

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The classification of 135 patients with either dermatomyositis (DM) or polymyositis (PM) showed 34 cases of DM and 56 cases of PM in adults, 6 cases of DM associated with cancer, 9 cases of DM in children, 16 cases of localized PM and 14 cases of an overlapping syndrome. Results of biological tests, erythrocyte sedimentation rate and serum enzyme determinations were inconstantly abnormal. The electromyograms were generally of a myogenic type with spontaneous activity in about half the cases.

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