Sree Chitra Tirunal Institute for Medical sciences and Technology ...

B) Investigations:1) Haemogram: Anemia was seen in 5 cases only out of total 84 cases. Leucocytosiswas seen in 37.9% .ESR was raised in 35.7%. SGOT /SGPT were raised in 56%2) CPK values:Mean CPK seen was 3200 lUlL in the cases with value more than 1 ,OOOIU/L. HighestCPK was 25,000 IU IL.Grading Frequencies in percentagesNormal 11.9< 1000 UIL 34.7> 1 OOOunits/L 53.4Table VII: Grading of raise in serum CPK level with their frequency3) Electromyography:Findings were suggestive of myopathy in 78 cases .Out of 78 cases 56 cases hadclassical inflammatory myopathy findings. Yield of Para spinal EMG were very low. Itwas inconclusive in 2 cases, normal in one & changes of neurogenic aetiology in 2 cases.Neuropathy was seen in total 8 cases .Two were with polymyositis & six were withoverlap syndrome5) Muscle Biopsy findings:Biopsy findings:InflammatorydiseaseNeurogenic changesNot doneNormalInconclusiveAlternate diagnosisFrequencies out of 84 casesmuscle 6459321Table VIII: Biopsy findings with their frequencyClassical perifascicular atrophy was seen in less than half of the cases with DM.Out of three patients who showed normal biopsy findings, two became asymptomaticwith treatment & one did not improve . Two had received steroids before biopsy for morethan 4weeks duration before biopsy. Among patients with neurogenic changes in thebiopsy, three-showed excellent improvement, one improved partially & remaining onepatient became bed bound in spite of treatment for long time. Repeat muscle biopsyduring the follow up of one patient, who did not show response to treatment wasconfirmed to have limb girdle muscular dystrophy.25