Late-onset multiple acyl-CoA dehydrogenase deficiency mimicking myositis in an elderly patient: a case report

Abstract Background Late-onset multiple acyl-CoA dehydrogenase deficiency (MADD) is a rare and treatable inherited lipid storage myopathy. Here, we report an elderly patient with MADD mimicking myositis. Case presentation An 80-year-old woman had progressive weakness in her limbs, exercise intoleran...

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Main Authors: Yiming Zheng, Yawen Zhao, Wei Zhang, Zhaoxia Wang, Yun Yuan
Format: Article
Language:English
Published: BMC 2020-12-01
Series:BMC Neurology
Subjects:
Online Access:https://doi.org/10.1186/s12883-020-02010-w
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author Yiming Zheng
Yawen Zhao
Wei Zhang
Zhaoxia Wang
Yun Yuan
author_facet Yiming Zheng
Yawen Zhao
Wei Zhang
Zhaoxia Wang
Yun Yuan
author_sort Yiming Zheng
collection DOAJ
description Abstract Background Late-onset multiple acyl-CoA dehydrogenase deficiency (MADD) is a rare and treatable inherited lipid storage myopathy. Here, we report an elderly patient with MADD mimicking myositis. Case presentation An 80-year-old woman had progressive weakness in her limbs, exercise intolerance, and no muscle pain for 3 months. The patient’s serum creatine kinase level was slightly elevated. The initial diagnosis was myositis. However, muscle biopsy showed many cytoplasmic vacuoles stained with oil red O, indicating the presence of lipid storage myopathy. The plasma acylcarnitine profile showed increased medium-chain and long-chain acylcarnitine species, consistent with the diagnosis of MADD. Riboflavin treatment dramatically improved muscle weakness. Conclusions MADD should be considered when evaluating elderly patients with subacute muscle weakness.
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spelling doaj.art-bf7b047f1a234e2a8bccda851b7bf8f12022-12-21T23:45:06ZengBMCBMC Neurology1471-23772020-12-012011310.1186/s12883-020-02010-wLate-onset multiple acyl-CoA dehydrogenase deficiency mimicking myositis in an elderly patient: a case reportYiming Zheng0Yawen Zhao1Wei Zhang2Zhaoxia Wang3Yun Yuan4Neurology Department, Peking University First HospitalNeurology Department, Peking University First HospitalNeurology Department, Peking University First HospitalNeurology Department, Peking University First HospitalNeurology Department, Peking University First HospitalAbstract Background Late-onset multiple acyl-CoA dehydrogenase deficiency (MADD) is a rare and treatable inherited lipid storage myopathy. Here, we report an elderly patient with MADD mimicking myositis. Case presentation An 80-year-old woman had progressive weakness in her limbs, exercise intolerance, and no muscle pain for 3 months. The patient’s serum creatine kinase level was slightly elevated. The initial diagnosis was myositis. However, muscle biopsy showed many cytoplasmic vacuoles stained with oil red O, indicating the presence of lipid storage myopathy. The plasma acylcarnitine profile showed increased medium-chain and long-chain acylcarnitine species, consistent with the diagnosis of MADD. Riboflavin treatment dramatically improved muscle weakness. Conclusions MADD should be considered when evaluating elderly patients with subacute muscle weakness.https://doi.org/10.1186/s12883-020-02010-wMADDMyositisLipid storage myopathyCase report
spellingShingle Yiming Zheng
Yawen Zhao
Wei Zhang
Zhaoxia Wang
Yun Yuan
Late-onset multiple acyl-CoA dehydrogenase deficiency mimicking myositis in an elderly patient: a case report
BMC Neurology
MADD
Myositis
Lipid storage myopathy
Case report
title Late-onset multiple acyl-CoA dehydrogenase deficiency mimicking myositis in an elderly patient: a case report
title_full Late-onset multiple acyl-CoA dehydrogenase deficiency mimicking myositis in an elderly patient: a case report
title_fullStr Late-onset multiple acyl-CoA dehydrogenase deficiency mimicking myositis in an elderly patient: a case report
title_full_unstemmed Late-onset multiple acyl-CoA dehydrogenase deficiency mimicking myositis in an elderly patient: a case report
title_short Late-onset multiple acyl-CoA dehydrogenase deficiency mimicking myositis in an elderly patient: a case report
title_sort late onset multiple acyl coa dehydrogenase deficiency mimicking myositis in an elderly patient a case report
topic MADD
Myositis
Lipid storage myopathy
Case report
url https://doi.org/10.1186/s12883-020-02010-w
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AT weizhang lateonsetmultipleacylcoadehydrogenasedeficiencymimickingmyositisinanelderlypatientacasereport
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