Methods:
Blood chemistries were significant for elevated creatine kinase (CK) at 4,050 IU/L, c-reactive protein (CRP) at 13.8 mg/dl, erythrocyte sedimentation rate (ESR) at 130 mm/hr, and elevated aldolase at 24 units/L. Liver enzymes were mildly elevated (AST 199 and ALT 119). Creatinine level was low at 0.3 mg/dl. ANA was negative; C3 was normal while C4 was slightly high. Table 1 summarizes the laboratory. The thyroid function test was normal. Workup for idiopathic inflammatory myopathy was negative including anti-Jo-1(Table 2). MRI of both lower extremities with STIR demonstrated diffuse myositis of the left and right thigh likely related to drug-induced myopathy but other infectious or inflammatory myopathies cannot be excluded(figure 1.1-1.2). No significant muscular fatty atrophy was observed on the MRI (figure 2.1-2.2).
Table 1 Summarization of laboratory during hospitalization.