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Mcleod syndrome (hemolysis, acanthocytosis, and increased serum creatine kinase): potential confusion with polymyositis

✍ Scribed by Lawrence P. Zyskowski; Thomas W. Bunch; H. Clark Hoagland; Howard F. Taswell; Virgil F. Fairbanks


Book ID
101647512
Publisher
John Wiley and Sons
Year
1983
Tongue
English
Weight
204 KB
Volume
26
Category
Article
ISSN
0004-3591

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✦ Synopsis


Polymyositis is an inflammatory muscle disease of unknown etiology. Clinical features include proximal muscle weakness and elevation of serum activity of enzymes derived from muscle. Since therapy with prednisone and/or cytotoxic agents often causes significant morbidity, it is especially important to be as sure as possible of the diagnosis. This generally requires a carefully performed and carefully read biopsy from an involved proximal skeletal muscle, a procedure that usually reveals the characteristic muscle fiber changes and mononuclear cell infiltration (1,2).

We describe a patient with increased serum creatine kinase (CK) activity, acanthocytosis, and normal muscle strength, who had initially been diagnosed as having polymyositis and treated accordingly. Further investigation revealed that he in fact has a rare disorder, the McLeod syndrome.

Case report. A 31-year-old physician jogger presented in June 1980 to determine whether azathiopnne should be added to his prednisone therapy for presumed polymyositis. He had been slightly icteric for at least 10 years and unconjugated hyperbilirubine-From the