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. 2014 Feb;20(2):185–191. doi: 10.3201/eid2002.131126

Table 2. Diagnostic test results, management, and outcome for persons with Anncaliia algerae myositis*.

Variable† Case-patient A Case-patient B Case-patient 1 (3) Case-patient 2 (5) Case-patient 3 (8)
Hemoglobin, g/L (130–180)‡ 95 122 ND 100 96
Lymphocytes ×109/L (1.5–4.0) 0.3 0.4 ND 0.2 0.1
CK U/L, peak (<200) 2,028 6,630 6,337 685 441
ALT, U/L (<45) 154 93 ND 66 50
AST, U/L (<45) 320 210 ND 129 70
ESR, mm/hr (0–14) 85 26 ND 38 30
CRP, mg/L (<3) 152 134 ND 16 41
Serum albumin, lowest, g/L (33–48) 21 19 ND 19 14
Serum creatinine, µmol/L (60–100)§ 44 202 ND 81 216
Urinary protein, g/24 h (<0.1)¶ 0.56 1.8 ND NT 1.53
Fecal stain# No microsporidia NT ND No microsporidia No microsporidia
Neurophysiology/EMG Myopathy; axonal neuropathy Myopathy; axonal neuropathy ND Myopathy; axonal neuropathy Myopathy; axonal neuropathy
Negative biopsy/fluid sites CSF Esophagus, stomach, duodenum Tracheal aspirate Bone marrow, lung, rectum, BAL, CSF NT
Positive biopsy sites Vastus lateralis Vastus lateralis Quadriceps femoris** Deltoid, tongue Deltoid
A. algerae sequence Yes Yes Yes Yes Yes
Immunosuppression reduced Yes Yes Yes Yes Yes
Albendazole Yes No Yes No Yes
Outcome Survived >18 mo Died, aspiration pneumonia Died, stroke Died, palliated Died, aspiration pneumonia

*ND, not described in publication; CK, creatinine kinase; ALT, alanine transaminase; AST, aspartate transaminase; ESR, erythrocyte sedimentation rate; CRP, C-reactive protein; EMG, electromyography; NT, not tested; CSF, cerebrospinal fluid; BAL, bronchoalveolar lavage.
†Biochemical and hematologic values are from the most recent visit to hospital, unless otherwise indicated. Reference values are in parentheses.
‡Anemia was normocytic.
§Case-patient A: serum creatinine was higher (150 μmol/L) at the first admission; case-patient B: baseline creatinine was ≈160μμmol/L; case-patient 3: preexisting renal impairment, with transplant.
¶Case-patient A: urinary myoglobin was negative; case-patient B urinary albumin:creatinine ratio 8 mo previously was normal; case-patient 3: urinary protein 2 mo previously was 0.68 g/24 h.
#Modified trichrome stain on concentrated feces.
**Component of quadriceps femoris not specified in publication.