PMC3350179_01
Muscle biopsy: (a) vacuolated fibers, (b) necrotic fibers, (c and d) endomysial and perivascular inflammation as well as necrotic fibers (black arrow).
CRIM.PEDIATRICS2011-670673.001.jpg
PMC3350179_01_CRIM.PEDIATRICS2011-670673.001.jpg
fig1
The biopsy revealed severe myonecrosis and inflammation (Figure 1). The slow decline in CK values as well as persistent weakness was consistent with severe muscle injury facilitated by profound hypothyroidism and moderate exercise (Figure 1). 