Myxedema neuropathy and myopathy

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Abstract
Manifestations suggesting neurologic and muscular impairment were sought in 25 patients with primary myxedema. Objective sensory and motor dysfunctions with decreased peripheral sensation and proximal muscle weakness were significant findings in this study. The pathologic alterations in nerve and muscle consisted of mucinous deposits in the endo- and perineurium as well as in the endo- and perimysium. The myelin sheaths and axis cylinders were altered. Both structure and staining changes were present in muscle fibers. The serum studies revealed a normal total protein concentration; however, separation of the various protein fractions revealed significantly decreased albumin and increased beta and gamma globulin. The increased gamma globulin was confirmed by an immunochemical technic. The total serum cholesterol and total serum lipoproteins were elevated significantly. Furthermore, the alpha-2 globulin lipoprotein was significantly elevated. Serum glycoprotein values were normal. The spinal fluid examination revealed increased total protein and gamma globulin fraction. Myxedema neuropathy and myxedema myopathy are terms suggested to define the clinical and pathologic picture seen in patients in this study.