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We appreciate Dr Schmitt's comments and observations. Although the cases of Shafiq et al and of Huntington, as mentioned in our article, were the only published reports of internalized capillaries that we could find, we do not doubt that these capillaries will be found at times in other neuromuscular disorders. Few, if any, structural alterations of skeletal muscle have the specificity that would be convenient for precise diagnosis. In our article, we did not state, nor do we think we implied, that internalized capillaries are pathognomonic for dominantly inherited pseudohypertrophic muscular dystrophy. Rather, the internalized capillaries, which were found with a high frequency in three of four of our patients, might serve as a histologic marker to help distinguish the apparently dominantly inherited Becker phenotype from the well-known sexlinked varieties of pseudohypertrophic muscular dystrophy, and from autosomal recessive muscular dystrophies with pseudohypertrophy.
Hastings BA, Groothuis DR, Vick NA. Internalized Capillaries-Reply. Arch Neurol. 1981;38(9):601. doi:10.1001/archneur.1981.00510090095018
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