There's a great Metabolic Mystery surrounding our new 'Educational Image' - A 42-year-old woman was investigated for exercise intolerance. She already had a medical follow-up because of a hypokinetic dilated cardiomyopathy identified at the age of 28 years and a chronic kidney disease, both secondary to a malignant hypertension episode. She complained about muscle pain and dyspnea on exertion, and was limited to a walking range of 200 m. She also experienced postexercise muscle pain. On clinical examination, no strength deficit was noted. She had mild amyotrophy of lower limbs and a symmetrical lipomatosis of her proximal upper limbs. Share your thoughts and then click for the answer: https://lnkd.in/eMg75SXR Leslie Bercu, patrizia Amati-Bonneau, Valérie Desquiret-Dumas, Vincent Procaccio, and françois maillot