case_images: PMC10184240_01
case_images: Portable chest X-ray showing cardiomegaly and mild pulmonary congestion.
case_images: 10.1177_21501319231172697-fig1.jpg
case_images: PMC10184240_01_10.1177_21501319231172697-fig1.jpg
case_images: fig1-21501319231172697
case_images: Chest X-ray and computed tomography (CT) angiography of the chest/abdomen/pelvis showed findings suggestive of volume overload with cardiomegaly, small bilateral pleural effusions, distended inferior vena cava and iliac veins, and body wall edema (Figure 1).
case_images: Rectus femoris muscle biopsy histopathology: muscle fibers failing to stain with cytochrome c oxidase (20x).
case_images: 10.1177_21501319231172697-fig2.jpg
case_images: PMC10184240_01_10.1177_21501319231172697-fig2.jpg
case_images: fig2-21501319231172697
case_images: Mitochondrial myopathy was in the differential diagnosis, and a surgical biopsy of the patient's rectus femoris revealed scattered ragged-blue fibers, scattered ragged-red fibers, and cytochrome-c oxidase negative fibers with increased perimysial and endomysial connective tissue, consistent with active and chronic primary mitochondrial myopathy (Figures 2-4).
case_images: Rectus femoris muscle biopsy histopathology: ragged-blue fibers diffusely reactive to succinate dehydrogenase staining (40x).
case_images: 10.1177_21501319231172697-fig3.jpg
case_images: PMC10184240_01_10.1177_21501319231172697-fig3.jpg
case_images: fig3-21501319231172697
case_images: Mitochondrial myopathy was in the differential diagnosis, and a surgical biopsy of the patient's rectus femoris revealed scattered ragged-blue fibers, scattered ragged-red fibers, and cytochrome-c oxidase negative fibers with increased perimysial and endomysial connective tissue, consistent with active and chronic primary mitochondrial myopathy (Figures 2-4).
case_images: Rectus femoris muscle biopsy histopathology: ragged-red fibers on modified Gomori trichrome stain (40x).
case_images: 10.1177_21501319231172697-fig4.jpg
case_images: PMC10184240_01_10.1177_21501319231172697-fig4.jpg
case_images: fig4-21501319231172697
case_images: Mitochondrial myopathy was in the differential diagnosis, and a surgical biopsy of the patient's rectus femoris revealed scattered ragged-blue fibers, scattered ragged-red fibers, and cytochrome-c oxidase negative fibers with increased perimysial and endomysial connective tissue, consistent with active and chronic primary mitochondrial myopathy (Figures 2-4).