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Mitochondrial myopathy presenting as Fibromyalgia: a case report

Monday 20 February 2012

 

From the Journal of Medical Case Reports:

 

Journal of Medical Case ReportsMitochondrial myopathy presenting as fibromyalgia: a case report

Mishal Abdullah, Sahana Vishwanath, Amro Elbalkhi and Julian L. Ambrus
Journal of Medical Case Reports 2012, 6:55
doi:10.1186/1752-1947-6-55
Published: 10 February 2012

Abstract (provisional)

Introduction

To the best of our knowledge, we describe for the first time the case of a woman who met the diagnostic criteria for fibromyalgia, did not respond to therapy for that disorder, and was subsequently diagnosed by biochemical and genetic studies with a mitochondrial myopathy. Treatment of the mitochondrial myopathy resulted in resolution of symptoms. This case demonstrates that mitochondrial myopathy may present in an adult with a symptom complex consistent with fibromyalgia.

Case presentation

Our patient was a 41-year-old Caucasian woman with symptoms of fatigue, exercise intolerance, headache, and multiple trigger points. Treatment for fibromyalgia with a wide spectrum of medications including non-steroidal anti-inflammatory drugs, antidepressants, gabapentin and pregabalin had no impact on her symptoms. A six-minute walk study demonstrated an elevated lactic acid level (5mmol/L; normal <2mmol/L). Biochemical and genetic studies from a muscle biopsy revealed a mitochondrial myopathy. Our patient was started on a compound of coenzyme Q10 (ubiquinone) 200mg, creatine 1000mg, carnitine 200mg and folic acid 1mg to be taken four times a day. She gradually showed significant improvement in her symptoms over a course of several months.

Conclusions

This case demonstrates that adults diagnosed with fibromyalgia may have their symptom complex related to an adult onset mitochondrial myopathy. This is an important finding since treatment of mitochondrial myopathy resulted in resolution of symptoms.

The complete article is available as a provisional PDF. The fully formatted PDF and HTML versions are in production.

 

The above originally appeared here.

 


 

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