Intranuclear inclusions in muscle, nervous tissue, and adrenal gland.

Abstract

A 30-year-old man had had chronic progressive wasting and weakness of muscles for 17 years. A muscle biopsy 5 years prior to death revealed myopathic changes were rimmed vacuoles and intranuclear inclusions which corresponded to "inclusion body myositis". At autopsy, intranuclear inclusions were observed in neurons, oligodendroglia, and in parenchymal cells of the adrenal medulla. Ultrastructurally, the inclusions in muscles, nervous tissue, and adrenal medulla were identical and consisted of abnormal tubulolinear structures measuring 10-20 nm in diameter. Similar inclusions have been reported in muscles with "inclusion body myositis" and in the nervous system with "neuronal intranuclear hyaline inclusion disease", respectively. Absence of clinical symptoms related to the CNS and adrenal gland, and well-preserved parenchymal cells in these organs of our patient suggest a benign nature of the disease except in the muscular system. Attempts to isolate a virus from the brain were fruitless . This patient may serve to connect both diseases in muscles and the nervous system, and to disclose the etiology of these inclusions.