Myoglobinuric Myopathy

Abstract

A 36-year old Negro female is presented with the non-exertional type of myo-globinuria, documented on two occasions. The myoglobin was identified electrophoretically on starch and cyanogum gel with orthotolidine stain. No heterogenous myoglobin bands were demonstrated. An ecg changes from NSR to RBBB between her second and third hospital visits. The possibility of direct cardiac involvement is considered. Electron microscopy showed numerous vesicular structures with a moderately dense central area and a peripheral layer of an electron dense granular material resembling glycogen. Serum enzymes and light microscopy are as previously described and are considered non-specific. An L.E. cell preparation was abnormal with clumping of leukocytes and phagocytosis of nuclear material. Phosphorylase determined on the patient''s muscle was normal. An ischemic exercise test showed an increase in lactate with exercise but to only one-half of that of the control.