Co-Existence of Polyneuropathy, Osteoporosis and Limb Girdle Muscular Dystrophy in a Patient with Ankylosing Spondylitis

Year 2022, Volume: 44 Issue: 2, 275 - 278, 28.02.2022

Hasan Armağan Uysal , Filiz Meryem Sertpoyraz , İrem Tiftikcioglu

https://doi.org/10.20515/otd.925826

Abstract

In this paper, we aimed to report a case of limb-girdle muscular dystrophy with diabetes mellitus who admitted to our outpatient clinic with paresthesia in all four limbs and swelling and pain in both ankles and waist. Nerve conduction study affirmed peripheral sensory polyneuropathy and osteoporosis was detected by bone mineral density analysis. A detailed evaluation revealed bilateral sacroiliitis, HLA-B 27 positivity, and elevation of erythrocyte sedimentation rate and serum C-reactive protein levels. Thus, the diagnose of ankylosing spondylitis was confirmed. It is worth presenting because the diagnoses of limb-girdle muscular dystrophy, diabetic polyneuropathy, osteoporosis, and ankylosing spondylitis were observed together in the same patient.

Keywords

Limb-girdle muskulerdistrofi, Ankilozanspondilit, Osteoporoz, Polinöropati, Limb-girdle muskulerdistrofi, Ankilozanspondilit, Osteoporoz, Polinöropati

Limb-Girdle Muskuler Distrofi, Polinöropati ve Osteoporozun Birlikte Görüldüğü Ankilozan Spondilit

Abstract

Bu yazıda, önceden Limb-girdle muskuler distrofi tanısı olan, polikliniğimize dört ekstremitede parestezi ve şişlik, hem bel hemde ayak bileğinde ağrı olması nedeniyle başvuran diyabetik bir hastayı sunmayı amaçladık. Sinir iletim çalışmasında periferik duysal nöpolinöropati olduğu doğrulandı ve kemik mineral yoğunluk analizi ile osteoporoz saptandı. Yapılan ayrıntılı değerlendirme ile bilateral sakroileit, HLA B27 pozitifliği, eritrosit sedimentasyon hızı ve serum C-reaktif protein yüksekliği ortaya koyuldu. Böylece, ankilozan spondilit tanısı kesinleştirildi. Hastada, Limb girdle muskuler distrofi, diabetik polinöropati, osteoporoz ve ankilozan spondilit tanılarının birarada gözlenmiş olması nedeniyle sunulma değer bulunmuşur.

Keywords

: Limb-girdle muskuler distrofi, Ankilozan spondilit, Osteoporoz, Polinöropati

References

• 1. Straub V, Bushby K. The chilhood limb-girdle muscular dystrophies. Semin Pediatr Neurol 2006;13:104-14.
• 2. Taurog JD, Chhabra A, Colbert RA. Ankylosing Spondylitis and Axial Spondyloarthritis. N Engl J Med. 2016;374(26):2563-74.
• 3. Sarıkaya F, AkdoğanA. Ankilozanspondilit ile HLA-B27, MEFV gen mutasyonları, ERAP1, IL12B ve IL23R gen polimorfizmleri arasındaki ilişki. Türk Biyokimya Dergisi. 2014;39(4):482–7.
• 4. Braun J, Baraliakos X, Buehring B, et al. Imaging of axial spondyloarthritis. New aspects and differential diagnoses. Clin Exp Rheumatol. 2018;114(5):35-42.
• 5. Khedr EM, Rashad SM, Hamed SA, et al. Neurological complications of ankylosing spondylitis: neurophysiological assessment. Rheumatol Int. 2009;29(9):1031-40.
• 6. Cooper RG, Freemont AJ. Paraspinal muscle fibrosis: a specific pathological component in ankylosing spondylitis. AnnRheumDis. 1991;50(11):755-9.
• 7. Faus-Riera S, Martínez-Pardo S. Muscle pathology in ankylosing spondylitis: clinical, enzymatic, electromyographicand histologic correlation. J Rheumatol. 1991;18(9):1368-71.
• 8. Akgul O, Gulkesen A. MR-defined fat infiltration of the lumbar paravertebral muscles differs between non-radiographic axial spondyloarthritis and established ankylosing spondylitis. Mod Rheumatol. 2013;23(4):811-6.
• 9. Alagoz AN, Öztürk Ş. Fasioskapulohumeral Musküler Distrofi ve Ankilozan Spondilit Birlikteliği. F.Ü.Sağ.Bil.TıpDerg. 2010:24(1):51–4.
• 10. Chen HH, Yeh SY, Chen HY, Lin CL, Sung FC, Kao CH. Ankylosing spondylitis and other inflammatory spondyloarthritis increase the risk of developing type 2 diabetes in an Asian population. RheumatolInt. 2014;34(2):265-70.
• 11. Serda Em, Mehtap Bozkurt, Ankilozan spondilitli hastalarda komorbit hastalıkların değerlendirmesi, Dicle tıp dergisi 2014;41(4):662-6.
• 12. Madej-Pilarczyk A, Kotruchow K. Emery-Dreifuss muscular dystrophy type 2 associated with mild peripheral polyneuropathy. FoliaNeuropathol. 2015;53(3):270-4.
• 13. Chan SH, Foley AR, Phadke R, et al. Limb girdle muscular dystrophy due to LAMA2 mutations: diagnostic difficulties due to associated peripheral neuropathy. Neuromuscul Disord. 2014;24(8):677-83.
• 14. Bell JM, Shields MD, Watters J. et al. Interventions to prevent and treat corticosteroid-induced osteoporosis and prevent osteoporotic fractures in Duchenne muscular dystrophy. Cochrane Database Syst Rev. 24;1(1):CD010899.