Abstract
A 27-year-old man presented to an internal medicine clinic to establish primary care. His past medical history was significant for elevated liver transaminases found during laboratory monitoring while taking isotretinoin for acne. He had an extensive workup spanning 7 years including serial hepatic function panels after withholding isotretinoin, viral serologies, and two liver biopsies, which eventually led to a diagnosis of an idiopathic elevation in serum transaminases. During his present evaluation, he endorsed complaints of significant muscle soreness with strenuous activity despite conditioning. Creatine kinase was found to be elevated at 11,778 U/l. Nerve conduction studies and electromyogram indicated a myopathy. DNA sequencing confirmed a diagnosis of limb-girdle muscular dystrophy. The aminotransferases are most notable for their association with liver pathology; however, they are also present in other tissues such as heart, kidney, and skeletal muscle. Muscle pathology, including the inherited muscular dystrophies, are often identified by elevations in creatine kinase, but can also be suggested by elevations of aminotransferases. This case illustrates that myopathies should be considered in patients with otherwise unexplained elevations in liver aminotransferases.
Published Version (Free)
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.