F-18-FDG PET/CT of drug-induced myopathy in a patient with chronic hepatitis B on long-term clevudine therapy

Abstract

A 41-year-old man underwent FDG PET/CT for evaluation of malignancy because of general ache and a severe weight loss of 22 kg over 3 months. He had a history of chronic hepatitis B and chronic glomerulonephritis for 14 years. He had been taking 30 mg of clevudine daily for 12 months for the treatment of chronic hepatitis B. On the MIP PET/CT image, diffusely increased whole-body skeletal muscle uptake was observed (a). The patient fasted overnight, and his serum glucose level was in the normal range. He did not engage in strenuous exercise prior to PET/CT. Laboratory data revealed markedly elevated serum creatine kinase (CK), CK-MB, and myoglobin. Incisional biopsy of the thigh muscle was diagnostic of inflammatory myopathy.