Ultrastructural features of the muscle fibers in congenital hypothyroidism

Summary Muscles of three patients (2 years, 2 years and 7 months, and 11 years of age) affected by congenital hypothyroidism due to dysgenesis of the thyroid gland were studied by electron microscope. The biopsies were performed on the quadriceps muscle. Several alterations were found in the ultrastructure of the muscle fibers. The contractile material underwent atrophy by two recessive processes: by reduction and by degeneration. The former, which affected mainly the white fibers, led to the progressive detachment of myofilaments from the periphery of the myofibrils while they maintainad a normal arrangement in the center. Consequently, their diameter decreased and their interfibrillar spaces enlarged. The latter enlargment, involving the red fibers, caused areas of dedifferentiation involving either the contractile apparatus or the other cell organelles. Modifications of the sarcolemma and basement membrane were seen in the fibers affected by the atrophying processes of the contractile material. Changes of the ultrastructure of the sarcoplasmic reticulum and of the T system were observed with numerous morphological abnormalities of the mitochondria. In addition, accumulation of glycogen and striking changes of the satellite cells were found. The ultrastructural findings are reviewed and discussed in relation to the literature on hypothyroid myopathy.