Ann Occup Environ Med.
2017 ;29(1):45. 10.1186/s40557-017-0201-0.
A case of generalized argyria presenting with muscle weakness
- Affiliations
-
- 1Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, 29 Saemunan-ro, Jongno-gu, Seoul, 03181 South Korea. iamjoo@hanmail.net.
- 2Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea.
- 3Department of Dermatology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea.
- 4Department of Dermatology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
- KMID: 2455023
- DOI: http://doi.org/10.1186/s40557-017-0201-0
Abstract
- BACKGROUND
Argyria is a rare irreversible cutaneous pigmentation disorder caused by prolonged exposure to silver. Herein, we report a case of generalized argyria that developed after chronic ingestion of soluble silver-nano particles and presented with muscle weakness.
CASE PRESENTATION
A 74-year-old woman visited our emergency room, complaining of fever and mental deterioration. She was diagnosed with acute pyelonephritis and recovered after antibiotic therapy. At presentation, diffuse slate gray-bluish pigmented patches were noticed on her face and nails. Two months prior to visiting our hospital, she was diagnosed with inflammatory myopathy and given steroid therapy at another hospital. We performed a nerve conduction study that revealed polyneuropathy. In skin biopsies from pigmented areas of the forehead and nose, the histopathologic results showed brown-black granules in basement membranes of sweat gland epithelia, which are diagnostic findings of argyria. We reviewed pathology slides obtained from the left thigh muscles and found markedly degenerated myofibers with disorganization of myofibrils without inflammatory reactions, consistent with unspecified myopathy, rather than inflammatory myopathy. The patient was diagnosed with generalized argyria with polyneuropathy and myopathy and transferred to a rehabilitation institution after being tapered off of steroids.
CONCLUSIONS
Clinicians should be aware of clinical manifestations of argyria and consider it in differential diagnosis when they examine patients who present with skin pigmentation and muscle weakness.
Keyword
MeSH Terms
-
Aged
Argyria*
Basement Membrane
Biopsy
Diagnosis, Differential
Eating
Emergency Service, Hospital
Female
Fever
Forehead
Humans
Muscle Weakness*
Muscles
Muscular Diseases
Myofibrils
Myositis
Neural Conduction
Nose
Pathology
Pigmentation Disorders
Polyneuropathies
Pyelonephritis
Rehabilitation
Silver
Skin
Skin Pigmentation
Steroids
Sweat Glands
Thigh
Silver
Steroids
