误诊为线粒体肌病的甲状腺功能减退性肌病一例

A case of hypothyroid myopathy misdiagnosed as a mitochondrial disease

目的探讨甲状腺功能减退性肌病的临床特点,病理特征,鉴别诊断及诊断标准,以减少误诊。方法分析1例早期误诊为线粒体肌病的甲状腺功能减退性肌病的临床资料。结果患者以"间断肌肉酸痛20d"为主要表现,肌肉活检见数个典型和非典型破碎红纤维,早期曾诊断为"线粒体肌病"。行甲状腺功能检查后提示甲状腺功能减退症,结合病史,症状体征,心肌酶谱及肌电图,肌肉活检,诊断为甲状腺功能减退性肌病。结论甲状腺功能减退性肌病的病理活检也可出现典型和非典型的破碎红纤维,应常规行甲状腺功能检查以期早期诊断,避免误诊。

Objective To investigate the clinical characteristics, pathological features, differential diagnosis and diagnostic criteria of hypothyroid myopathy in order to reduce the misdiagnosis. Method Analysis the clinical data of one case of hypothyroid myopathy which was diagnosed as mitochondrial myopathy.Results A patient was suffered from indicated intermittent muscle soreness for more than 20 days as the main performance ,muscle biopsy showed a lot of typical and atypical ragged red fibers, the diagnosis was mitochondrial myopathy.Thyroid function tests after diagnosis Hashimoto＇s thyroiditis and hypothyroidism, combining with the history, symptoms and signs, myocardial enzyme spectrum and electromyography, muscle biopsy, immunohistochemical staining,The diagnosis was hypothyroid myopathy. Conclusion Pathological biopsy of hypothyroidism may also occured typical and atypical ragged red fibers, it is important to take thyroidt tests to reconfirm diagnosis.