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Changes in muscle fibre type in hypothyroid myopathy were studied by serial percutaneous needle biopsy of vastus lateralis before and during treatment with L-thyroxine. A type II fibre atrophy and loss was found, which correlated with the clinical and biochemical evidence of a myopathy. The type II fibre atrophy was corrected by L-thyroxine but type II fibre loss was still apparent in severely myopathic patients up to two years after starting treatment. The pathogenesis and significance of type II fibre atrophy and loss are discussed in relation to prognosis.
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