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CC BY-NC-ND 4.0 · Arq Neuropsiquiatr 2018; 76(01): 59
DOI: 10.1590/0004-282X20170175
IMAGES IN NEUROLOGY

Proximal limb weakness and amyotrophy in a man with silicosis

Fraqueza muscular proximal e amiotrofia em um homem com silicose
Paulo Victor Sgobbi de Souza
1   Universidade Federal de São Paulo, Divisão de Doenças Neuromusculares, Departamento de Neurologia e Neurocirurgia, São Paulo SP, Brasil.
,
Thiago Bortholin
1   Universidade Federal de São Paulo, Divisão de Doenças Neuromusculares, Departamento de Neurologia e Neurocirurgia, São Paulo SP, Brasil.
,
Fernando George Monteiro Naylor
1   Universidade Federal de São Paulo, Divisão de Doenças Neuromusculares, Departamento de Neurologia e Neurocirurgia, São Paulo SP, Brasil.
,
Wladimir Bocca Vieira de Rezende Pinto
1   Universidade Federal de São Paulo, Divisão de Doenças Neuromusculares, Departamento de Neurologia e Neurocirurgia, São Paulo SP, Brasil.
,
Beny Schmidt
1   Universidade Federal de São Paulo, Divisão de Doenças Neuromusculares, Departamento de Neurologia e Neurocirurgia, São Paulo SP, Brasil.
,
Acary Souza Bulle Oliveira
1   Universidade Federal de São Paulo, Divisão de Doenças Neuromusculares, Departamento de Neurologia e Neurocirurgia, São Paulo SP, Brasil.
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A 55-year-old man presented with four-year history of progressive muscle wasting and weakness. His medical history disclosed advanced stage silicosis. The examination revealed flaccid quadriparesis with proximal amyotrophy. Serum creatine-kinase levels and screening for metabolic and inflammatory disorders were unremarkable. Muscle biopsy showed myopathic findings and the presence of abnormal amorphous and heterogeneous intracytoplasmic and subsarcolemmal content ([Figure]).

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Figure Chest CT-scan and muscle biopsy findings in silicosis. (A, B) Axial chest CT-scan showing bilateral severe advanced stage interstitial lung disease with marked lung architectural distortion (black arrow). Deltoid muscle biopsy showing abnormal subsarcolemmal and intracytoplasmic content disclosed in red in trichrome Gomori stain (C-E; white arrow) and black in NADH-TR histochemistry (F-H; white arrow-head).

Toxic myopathies can result from environmental and occupational exposure to toxic agents[1]. Silicosis results from the deposition of crystalline silicon dioxide (silica) in lung and is associated with different systemic involvement, including osteoporosis, susceptibility to autoimmune disorders, constrictive pericarditis[2] and, rarely, myopathy.



Publication History

Received: 15 February 2017

Accepted: 04 October 2017

Article published online:
30 August 2023

© 2023. Academia Brasileira de Neurologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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  • References

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  • 2 Leung CC, Yu ITS, Chen W. Silicosis. Lancet. 2012;379(9830):2008-18. https://doi.org/10.1016/S0140-6736(12)60235-9