Title : Heterotopic ossification of skeletal muscle: A complication of stiff person syndrome
Abstract:
This case report highlights how Stiff Person Syndrome (SPS) can be associated with severe complications, including heterotopic ossification (HO). HO of skeletal muscle has not been described in the pathophysiology of SPS and has been described in only one other case report of SPS in which the hip and knee joints were affected. We present this phenomenon to alert clinicians to a potential complication of SPS that can lead to unnecessary testing and delays in patient care.
Background and Objectives: Stiff person syndrome (SPS) is a heterogeneous neurological condition, which is thought to be autoimmune in nature. SPS is characterized by a combination of muscle hypertonia, reflex and action-induced spasms, and continuous motor activity at rest. SPS is often associated with the presence of antibodies to GAD 65.
Methods: We review the clinical manifestations of SPS and the entities associated with GAD 65 antibodies and describe the case of a previously healthy 62 year old man who presented to the hospital for evaluation of acute on chronic truncal and lower extremity spasms.
Results: Our patient was found to have elevated GAD 65 antibody titers and radiographic evidence of heterotopic ossification of the psoas muscles.
Discussion: Heterotopic ossification (HO) affecting skeletal muscle in patients with SPS has not been previously described. We present this phenomenon to alert clinicians to a potential complication of SPS that can lead to unnecessary testing and delays in patient care.
