Angel Hristovski-Duchenne Muscular Dystrophy, sinus tachycardia-(Northern Macedonia)

Patient name: Angel Hristovski
Gender: male
Age: 12 years old
Nationality: Northern Macedonia
Diagnosis: 1.Duchenne Muscular Dystrophy 2.Sinus tachycardia

Condition on admission:
The patient’s main symptom is progressive myasthenia gravis, unable to walk, limb movement disorder, no sensory abnormality, no defecation disorder.

Physical examination:
The patient's blood pressure 100/60mmHg, heart rate 95-120 beats / min, 20 breaths / min, body temperature 36.5 degrees, blood oxygen 97%. There was no yellow stain or bleeding spot on his skin. His lungs had clear breathing sounds and no dry-wet rales. His heart rate was fast and irregular and there was no murmur. There's nothing wrong with his abdomen.

Nervous system physical examination:
The patient was in a clear mind and speaks well. His memory and calculation abilities were normal. His cranial nerve examination showed no abnormality. The proximal muscle strength of his left upper limb was grade 2-, his distal and grip strength was grade 3-, the proximal muscle strength of his right upper limb was grade 3-, his distal muscle strength was grade 3-, and the muscle strength of his both lower limbs was grade 2-. His right hand could touch his forehead, his left hand could only touch his forechest, and his left upper arm could not be lifted; his lower limbs could not be translated, and his left lower limbs were worse than his right ones; it was difficult for him to bend his knees to support them. He had low muscle tone in his limbs. The tendon reflex of his extremities was weakened. His pathological symptoms were negative. His sensation examination was normal. His bilateral finger nose test and rapid rotation test could not be completed due to his poor muscle strength. He could not complete the bilateral calcaneus knee tibia test. He couldn't stand on his lower limbs. His meningeal irritation sign was negative. He tested creatine kinase CK= 3020U/L (50-310). His electrocardiogram showed short PR interval, sinus tachycardia with arrhythmia.

Treatment process:
The diagnosis of his admission was "Duchenne Muscular Dystrophy, sinus tachycardia". Mesenchymal stem cells were given him to repair muscle fiber injury, neural stem cells provided neurotrophic support, and CAST therapy was assisted by comprehensive nutrients, nutritional factors and other drugs, and combined with comprehensive rehabilitation therapy.

After treatment:
The motor function and muscle strength of his extremities were significantly improved, including grade 3 of proximal muscle strength of his left upper limb, grade 3 of distal and grip strength of his left upper limb, grade 3 of proximal muscle strength of his right upper limb, grade 3+ of distal muscle strength of his right upper limb, and grade 2+ of muscle strength of his both lower limbs. His both hands could touch the top of the head, his left arm could be raised about 15 cm in the supine position, and the completion of the movement in his sitting position was more flexible than that in the supine position; the speed of leg flexion of his both lower limbs was faster, and his knee flexion position could be maintained stably, and his adduction and abduction could resist some resistance. His overall muscle strength was about 30% higher than that at the time of admission. His heart rate improved, his average heart rate was 80-90 / min after exercise, and his creatine kinase decreased significantly compared with that at his admission.