A 43-Year-Old Man Comes to the Office with Muscle Weakness

A 43-year-old man comes to the office with muscle weakness.  His symptoms began 6 weeks ago and are worst in the hips and shoulders.  The weakness has had a progressive course so that he is now having difficulty rising from chairs and combing his hair.  The patient has had to reduce his regular exercise regimen due to weakness and has requested a modified work schedule for his job as a building maintenance manager.  He has no history of spinal injury and no neck pain.  Past medical history is insignificant, and the patient takes no medications.  Muscle biopsy reveals major histocompatibility complex class I molecule overexpression on the sarcolemma with CD8⁺ lymphocyte infiltration.  Which of the following is the most likely cause of this patient's condition?

A) Diffuse systemic sclerosis
B) Eaton-Lambert syndrome
C) Myasthenia gravis
D) Polyarteritis nodosa
E) Polymyalgia rheumatica
F) Polymyositis

Correct Answer:

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