Posted 11/9/2012 8:57 AM (GMT -5)
I don't know if anyone's posted this yet, so I'll post it.
Sorry if it's already been posted and/or discussed.
Department of Medicine, SUNY at Buffalo School of Medicine, 100 High Street, Buffalo, NY 14203, USA
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Journal of Medical Case Reports 2012, 6:55 doi:10.1186/1752-1947-6-55
The electronic version of this article is the complete one and can be found online at: http://www.jmedicalcasereports.com/content/6/1/55
Received: 21 October 2011
Accepted: 10 February 2012
Published: 10 February 2012
© 2012 Abdullah et al; licensee BioMed Central Ltd.
This is an open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
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 (5 mmol/L; normal < 2 mmol/L). Biochemical and genetic studies from a muscle biopsy revealed a mitochondrial myopathy. Our patient was started on a compound of coenzyme Q10 (ubiquinone) 200 mg, creatine 1000 mg, carnitine 200 mg and folic acid 1 mg 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.
http://www.jmedicalcasereports.com/content/6/1/55