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Abstract Details

Prevalence of neuropathy in patients with minimally symptomatic hyperCKemia
Neuromuscular and Clinical Neurophysiology (EMG)
Neuromuscular and Clinical Neurophysiology (EMG) Posters (7:00 AM-5:00 PM)
069
We sought to determine the frequency of neuropathy in patients with minimally symptomatic hyperCKemia. 
Minimally symptomatic hyperCKemia is a common referral but the diagnosis remains elusive in most patients.  
Patients with hyperCKemia underwent skin biopsy at the distal leg and had detailed chart review of their diagnostic evaluation.
A total of 33 subjects with minimally symptomatic hyperCKemia were included.  Myalgia or cramps, the most common symptoms, were present in 24 (73%).  Six (18%) had biopsy confirmed myopathy.  Seven (21%) had clinical and electrodiagnostic evidence of large fiber neuropathy.  Eight (24%) had small fiber neuropathy based on neuropathic signs or symptoms, normal nerve conduction studies and reduced intra-epidermal nerve fiber density at the distal leg . Sixty percent of subjects with neuropathy were found to have an etiology; 5 with diabetes/pre-diabetes, 2 with monoclonal gammopathy, and 1 each with vitamin B12 deficiency and peripheral nerve vasculopathy.  Reduced intraepidermal nerve fiber density was 2½ times more common in those with reduced pin prick sensation on examination and 4 times less common in those with myopathy. 
Neuropathy, both large and small fiber, is common in patients with minimally symptomatic hyperCKemia.  This should help direct investigations and treatment for patients often complaining of myalgia or cramps.   
Authors/Disclosures
Bhavesh Trikamji, MD (University of California Los Angeles)
PRESENTER 		Dr. Trikamji has nothing to disclose.
Glenn Lopate, MD (Washington University School of Medicine) Dr. Lopate has nothing to disclose.
Julaine M. Florence (Washington University) Ms. Florence has nothing to disclose.
No disclosure on file
Marie Wencel, CCRP (University of California, Irvine) Ms. Wencel has nothing to disclose.
Tahseen Mozaffar, MD, FÂ鶹´«Ã½Ó³»­ (University of California Irvine) Dr. Mozaffar has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Alexion Pharmaceuticals. Dr. Mozaffar has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Argenx. Dr. Mozaffar has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Sanofi-Genzyme. Dr. Mozaffar has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Amicus. Dr. Mozaffar has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Grifols. Dr. Mozaffar has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Astellas Gene Therapy. Dr. Mozaffar has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Bayer. Dr. Mozaffar has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sarepta. Dr. Mozaffar has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Applied Therapeutics. The institution of Dr. Mozaffar has received research support from NIH. The institution of Dr. Mozaffar has received research support from Muscular Dystrophy Association. The institution of Dr. Mozaffar has received research support from Sanofi. The institution of Dr. Mozaffar has received research support from Argenx. The institution of Dr. Mozaffar has received research support from Amicus Therapeutics. The institution of Dr. Mozaffar has received research support from Astellas Gene Therpay. The institution of Dr. Mozaffar has received research support from Cartesian. The institution of Dr. Mozaffar has received research support from Cabaletta. Dr. Mozaffar has received personal compensation in the range of $500-$4,999 for serving as a Study Section Member with NIH.
Alan Pestronk, MD, FÂ鶹´«Ã½Ó³»­ (Washington University in Saint Louis - Neurology) The institution of Dr. Pestronk has received research support from Jain. The institution of Dr. Pestronk has received research support from Fulcrum. The institution of Dr. Pestronk has received research support from Argenyx. The institution of Dr. Pestronk has received research support from NeuroNext.