Anna-Hereditary Inclusion Body Myopathy-(Israel)

Name: Anna 
Sex: Female
Nationality: Israeli
Age: 50Y
Diagnosis: Hereditary inclusion body myopathy( HIBM)

Before treatment:  
The patient had foot drop 7 years ago. She was unable to run or walk a couple months later, her left leg was weak and it was hard for her to raise her legs. She went to a local hospital and was diagnosed with HIBM. Her condition became better after taking medicines. The muscle power of her waist and back were weak 3-4 years ago, it was hard for her to sit up from a lying position or stand up from sitting position. The muscle power of her arms also became weak and it was easier for her to feel tired. She felt short of breath after movement. At present her gait is abnormal, she needs help with going up and down stairs but she can get up from bed, turn over her body and sit up by herself.
Her spirit, diet, urination and defecation functions are normal. She sleeps 10 hours per day.

Admission PE:
Bp: 111/68mmHg, Hr: 78/min, breathing rate: 18/min, body temperature: 36.3 degree. Blood oxygen concentration was 95-96%, her height 156cm, weight 82Kg. Nutrition status is good with normal physical development. There is no injury or bleeding spots of her skin and mucosa, no blausucht and no tonsil swelling. The respiratory sounds in both lungs were clear, chest movement was fine and there was no dry or moist rales. The heart beat is powerful with regular cardiac rhythm and with no obvious murmur in the valves. The abdomen was bulging and soft, with no masses or tenderness. The liver and spleen were normal and there was no edema of the legs.

Nervous System Examination:
Patient was alert and had clear speech. The examination of memory,  orientation and calculation abilities were normal. Both pupils were equal in size and round, diameter of 3.0 mm, react well to light and the eyeballs can move freely. Her bilateral forehead wrinkle and nasolabial fold are symmetrical, she could close eyes powerfully. The tongue can extend out as normal, showing teeth was normal and she can bulge her cheeks but with air leakage. The bilateral soft palate can lift powerfully. She can turn her neck and shrug powerfully. The proximal side muscle volume of the arms was decreased slightly, muscle power was 3+ degrees, the distal side muscle power was 4- degrees. The right leg proximal side muscle power was 2+ degrees, distal side muscle power was 2 degrees. The muscle power of the left leg was 2- degrees. Her feet could not perform the dorsiflex movement. 4 limbs muscle tone was decreased, tendon reflex was normal. The abdominal reflex was normal, bilateral palm-jaw reflex was negative, the Hoffmann sign, Rossilimo sign and Babinski signs were negative. Her sensory examination was normal by gross measure. Finger opposite movement, finger to nose test and fast alternate movement were normal. She could not perform the heel-knee-tibia test because of weakness. Her meningeal irritation sign was negative.

After the admission she received related examinations and received 3 times cells regeneration treatment to repair her damaged muscle cells, replace dead cells, nourish cells, regulate her immune system and improve blood circulation. This was done with rehabilitation training.     

After 15 days treatment her endurance improved, she could lift her arms much easier, even holding heavy things. The proximal side muscle power of the arms increased to 4+ degrees, the  abductor muscle power of the arms increased to 3+ degrees. Her back and waist muscle power increased also and now she could stand up from sitting posture without support. Her toes could move with much more  flexibility.

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