XXXX with unusually long duration: Report on clinical, laboratory and muscle imaging findings in two cases.

@entity1 @entity2086 @entity1184 @entity4 @entity908 @entity241 @entity1955 @entity393 @entity925 @entity1954 @entity4653
Two adult @entity1 presented with the rare @entity241 ( @entity241 ). Case 1: A 35-year-old male @entity1 had progressive stiffness of lower limbs of 13 years and generalized @entity2086 and @entity925 of 3 years duration. Had periorbital @entity4 , dry skin, generalized @entity2086 and @entity4653 with hoarseness. Muscle power was normal. Jaw jerk and deep tendon reflexes were exaggerated. Case 2: A 24-year-old male @entity1 presented with @entity2086 from childhood, slowness in motor activities and @entity393 . For 6 months, he had severe @entity925 , cramps and further increase in @entity1184 . He had yellow tinged, dry skin, hoarseness of voice, gross @entity2086 and minimal weakness. Both had markedly elevated serum @entity908 kinase (CK) levels and high thyroid stimulating hormone, low free @entity1954 and free @entity1955 levels. @entity1955 treatment demonstrated remarkable reduction in muscle bulk at 2 months in both and no symptoms at 6 months. Magnetic resonance imaging of lower limbs in both cases revealed almost identical features with involvement of the muscles of posterior and adductor compartment of thighs and posterior and lateral compartments of the legs. Differential diagnosis of long duration muscle pseudohypertrophy and elevated CK levels should include @entity241 .
