A unique case of hemi-tongue pseudohypertrophy, necrotizing myopathy, and erythema nodosum.

Koji Abe,Kota Sato,Mami Takemoto,Nozomi Hishikawa,Shang Jinwei,Toru Yamashita,Yasuyuki Ohta,Yoshiaki Takahashi

doi:10.4081/ni.2018.7852

Abstract

A 46-year-old woman developed slowly progressive tongue weakness with a pseudohypertrophic change on the right side of her tongue. She subsequently developed weakness in her proximal lower extremities, skin erythema and a sustained increase of muscle enzymes at 11 M after the onset. A biopsy of the quadriceps muscle showed necrotizing myopathy and a skin biopsy showed erythema nodosum. The present case showed characteristic clinical manifestations that may represent a rare variant of sarcoidosis.

Highlights

A biopsy of the quadriceps muss cle showed necrotizing myopathy and a u skin biopsy showed erythema nodosum. l The present case showed characteristic clinia ical manifestations that may represent a rare variant of sarcoidosis
Erc Introduction m we report a 46-year-old woman m who developed slowly progressive tongue o weakness with a pseudohypertrophic c change, and consecutively displayed an - increase in muscle enzymes, weakness in n her proximal lower extremities, and skin No erythema at 11 M after the onset. Right side of her tongue, both in the T1 weighted image (T1WI) and the T2 weighted image (T2WI) (Figure 1F and G, arrowheads), which was suppressed in fat-suppression T1WI and was not enhanced by gadolinium (Gd) (Figure 1H, arrowhead)
A woman began to feel a swelling of the IU/L), ALT (45 IU/L), and LDH (616 IU/L). hypoglossal nerve palsy, but tongue pseudotongue at the age of 46

Summary

Introduction

MRI showed no lesion in the medulla oblongata or hypoglossal canal (Figure 1E). Erc Introduction m we report a 46-year-old woman m who developed slowly progressive tongue o weakness with a pseudohypertrophic c change, and consecutively displayed an - increase in muscle enzymes, weakness in n her proximal lower extremities, and skin No erythema at 11 M after the onset. A tongue biopsy of the right side after 7 M showed that it was edematous and fibrotic without any striated muscles (Figure 1I) but without any invasion of malignant cells, infiltration of inflammatory cells, or granuloma.

Results

Conclusion