Acute quadriplegic myopathy with loss thick (myosin) filaments following heart transplantation

Acute quadriplegic myopathy with loss of thick (myosin) filaments (AQM-LTF) is an acute toxic myopathy observed in critically ill patients and is char acterized by proximal or diffuse weakness of extremities and difficulty in weaning from mechanical ventilation. In recent years, this myopathy has bee n described in transplanted patients, although only 5 cases have been repor ted following heart transplantation. We present 3 new cases and review the previous literature. We conclude that the clinical picture and outcome of A QM-LTF in heart-transplanted patients do not differ from those observed in other critically ill patients (transplanted and non-transplanted). Therefor e, because AQM-LTF is often clinically suspected muscle biopsy should be qu ickly performed to confirm the diagnosis so that physical therapy may begin as soon as possible.