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Role of repeat skeletal muscle biopsy: How useful is it?


Correspondence to (and current affiliation): S. A. Goutman, Department of Neurology, University of Michigan, 1C327 UH EMG LAB SPC 5036, 1500 East Medical Center Drive, Ann Arbor, MI 48109-5036. E-mail:


Introduction: The role of skeletal muscle biopsy is established; however, to our knowledge, no study has systematically evaluated the utility of a repeat biopsy. Methods: This study was a retrospective clinicopathologic review of 66 patients (mean age 38.1 years, 39 men) with at least 1 repeat muscle biopsy obtained between February 1992 and November 2011. Clinical data determined how results of the subsequent biopsy impacted patient management. Results: Repeat biopsy yielded a definitive diagnosis in 16 of 66 patients (24%). In the remaining patients, a repeat study provided clinically useful information or directly answered the clinical question (n = 30, 45%) by excluding a differential consideration (n = 19), supporting treatment continuation (n = 8), prompting treatment change (n = 1), confirming the original diagnosis (n = 1), or establishing a likely diagnosis (n = 1). Conclusion: Repeat muscle biopsy plays a role in the evaluation of patients with suspected myopathy in certain clinical circumstances. Muscle Nerve 47: 835–839, 2013