Glycogen storage disease type V

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Flashcards

Glycogen storage disease type V

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Questions

USMLE® Step 1 style questions USMLE

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A 20-year-old man comes to the emergency department with painful muscle spasms. He notices that these episodes worsen after a run and seem to improve after brief periods of rest. His past medical history includes a right knee ACL tear. His temperature is 37.0°C (98.6°F), pulse is 80/min, respirations are 16/min, and blood pressure is 125/75 mmHg. Abdominal examination is unremarkable. Rapid fingerstick glucose is 80 mg/dL. Serum creatine kinase levels are elevated. Laboratory investigations are shown below:

 Serum 
 Sodium   140 mEq/L 
 Potassium  4 mEq/L 
 Creatinine   1.3 mg/dL 
 Creatine kinase  645 U/L 
 Urine  
 BUN/Cr  <15 
 Blood   Positive  
 Erythrocytes  0/hpf 
 Leukocytes  2/hpf 
 Fractional excretion of sodium (FENa  >2%  

Electrocardiogram and echocardiogram are unremarkable. Which of the following is the most likely diagnosis? 

External References

First Aid

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2023

2022

2021

Arrhythmias

McArdle disease p. 85

McArdle disease p. 85

Myoglobinuria

McArdle disease p. 85

External Links

Summary

Glycogen storage disease type V, also known as McArdle's disease, is a glycogen metabolism disorder in which an enzyme known as muscle phosphorylase (myophosphorylase) is deficient. Muscle phosphorylase is necessary to break down glycogen stored in muscles into usable glucose. People with Glycogen storage disease type V can present with rhabdomyolysis, myoglobinuria, exercise intolerance, and muscle weakness.

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