Case: 50ish yo man with myotonic dystrophy diagnosed last year who states that
he has had slight diarrhea after meals for many years, but now presents with 3
days of severe diarrhea and vomiting to the point of dehydration and renal
failure. A work-up for infection (blood and stool cultures, fecal fat/WBC,
fecal ova/parasites) is completely negative. And he is afebrile with a normal
white count. His muscle strength is 3/5 and neuro exam non-focal except for
slight ptosis. The vomiting and diarrhea resolve spontaneously with no oral
intake.
It has been reported that though myotonic dystrophy is primarily a disorder of
skeletal muscle, the GI tract can also be affected.
Question: How often does myotonic dystrophy present with GI symptoms
(diarrhea...) as a main complaint? Can DM present with acute exacerbations, as
may be the case in this person?
Craig Hou
UCLA medical student
