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It is therefore important to be aware of morphological alterations that can be caused by systemic factors or natural ageing. Chronic limb ischaemia is frequent in elderly individuals. This study was performed to examine histopathological and mitochondrial changes in muscle in patients with chronic critical limb ischaemia. Muscle biopsy of skeletal muscle of the lower limb of patients with chronic ischaemia leading to amputation was performed and compared with muscle biopsies of healthy, age\u2010matched controls. The histopathological abnormalities included fibrosis, necrosis, atrophy, glycogen depletion, internal nuclei, rimmed vacuoles, fibre type grouping, cytochrome <jats:italic>c<\/jats:italic> oxidase deficient fibres, <jats:styled-content style=\"fixed-case\">MHC<\/jats:styled-content>\u2010I upregulation, and signs of microangiopathy. The only alteration found in age\u2010matched controls was a few cytochrome <jats:italic>c<\/jats:italic> oxidase deficient fibres. There were also increased levels of multiple mitochondrial <jats:styled-content style=\"fixed-case\">DNA<\/jats:styled-content> deletions in ischaemic muscles compared with controls. Critical limb ischaemia is associated with significant histopathological changes in muscle tissue and also increased levels of mitochondrial <jats:styled-content style=\"fixed-case\">DNA<\/jats:styled-content> deletions. Since the alterations mimic different primary myopathic changes, chronic ischaemia is important to consider as a differential diagnosis in elderly individuals, investigated with muscle biopsy for muscle disease.<\/jats:p>","DOI":"10.1111\/apm.12586","type":"journal-article","created":{"date-parts":[[2016,8,19]],"date-time":"2016-08-19T12:13:30Z","timestamp":1471608810000},"page":"935-941","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Histopathological changes in skeletal muscle associated with chronic ischaemia"],"prefix":"10.1111","volume":"124","author":[{"given":"Sara","family":"Roos","sequence":"first","affiliation":[{"name":"Department of Pathology The Sahlgrenska Academy at the University of Gothenburg Gothenburg Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ing\u2010Marie","family":"Fyhr","sequence":"additional","affiliation":[{"name":"Department of Pathology The Sahlgrenska 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