| Phenotype details |
history immune thrombocytopenic purpura (HP:0001973, like elder brother), hypothyroidism (HP:0000821); bilateral foot drop (HP:0009027), positive Gower's sign (HP:0003391), significant weakness lower extremities (HP:0007340), muscle testing 5/5 strength quadriceps, 3/5 other proximal/distal muscles lower extremities, 4/5 upper extremities proximal muscles, 5/5 flexor pollicise lunges, 2/5 flexor digit rum profoundus, intact sensation and cranial nerve; EMG left biceps/deltoid muscles normal motor unit interference pattern, low amplitude, short duration motor unit action potential without abnormal spontaneous activity. Left tibialis anterior revealed a few polyphasic motor unit action potentials, nerve conduction in normal limits; CPK increased 347 IU/L (32-267) (HP:0003236); biopsy muscle rimmed vacuolar myopathy (HP:0003805), no inflammatory infiltrate |