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At least 757 records · Page 42Linked to original sources
PubMed2003

Inclusion body myositis in connective tissue disorders: case report and review of the literature.

We report a patient with systemic lupus erythematosus (SLE) and secondary Sjögren's syndrome (SS) who developed inclusion body myositis (IBM) which, contrary to the typical presentation of this disorder, was symmetrical in nature although the diagnosis was only made after electron microscopy was performed. Therapy with increased doses of methotrexate proved to be beneficial, with the patient having full recovery after 8 months of therapy. It appears that a subset of IBM may be related to autoimmune disorders, an issue that was disputed in the past, and these patients may have a better prognosis than typical IBM patients. This is the first case report of IBM in a patient who had the dual diagnosis of SLE and SS.

Biopsy, Needle↗
PubMed2004

A case of anti-Jo1 myositis with pleural effusions and pericardial tamponade developing after exposure to a fermented Kombucha beverage.

The pathogenesis of the idiopathic inflammatory myopathies has been postulated to be an environmental trigger causing the expression of the disease in a genetically predisposed patient. We report a case of anti-Jo1 antibody-positive myositis which was associated with pleural effusions, pericardial effusion with tamponade, and 'mechanic's hands', probably related to the consumption of a fermented Kombucha beverage. Kombucha 'mushroom', a symbiosis of yeast and bacteria, is postulated to be the trigger for our patient's disease owing to the proximity of his symptoms to the consumption of the Kombucha beverage.

Antibodies, Antinuclear↗
PubMed2006

Inflammatory myositis complicating hypocomplementemic urticarial vasculitis despite on-going immunosuppression.

We present a patient with previously diagnosed hypocomplementemic urticarial vasculitis syndrome, with skin, lung, and renal involvement, who presented with congestive cardiac failure. During the course of her hospitalization, she was also found to have profound proximal muscle weakness in both upper and lower limbs associated with raised creatinine kinase levels. A muscle biopsy was performed, which demonstrated evidence of an inflammatory myositis with vasculitis, which had returned despite on-going immunosuppression. This occurrence of a new autoimmune disease may well be an example of the "waste disposal" hypothesis.

Antirheumatic Agents↗
PubMed1999

Inflammatory bowel disease and myositis.

A patient with Crohn's disease developed proximal muscle weakness, increased serum creatine phosphokinase activity and electromyographic abnormalities. A muscle biopsy was non-diagnostic. Although rare, myositis should be included in the differential diagnosis of muscle weakness in patients with inflammatory bowel disease.

Creatine Kinase↗
PubMed2001

Glycogenosis type V (McArdle's disease) mimicking atypical myositis.

A 13-year-old girl was referred to our clinic because of a positive rheumatoid factor test, muscle pain and weakness. Laboratory evaluation revealed an increased ESR, hypergammaglobulinaemia, antinuclear antibodies, circulating immune complexes, complement consumption and elevated serum creatine kinase (CK) activity. A needle biopsy of the dolent muscle showed normal routine histology. Immunohistochemistry disclosed single lymphocytes and a weak myocytic HLA class I expression. The diagnosis of myositis was considered and corticosteroids were initiated, leading to an increase of complement levels and a decrease of CK-activity and ESR. She subjectively felt stronger but still reported exercise intolerance and metabolic myopathy was considered. Myophosphorylase activity was completely lacking, establishing the diagnosis of McArdle's disease. CK level was found to be elevated in an obese 4-year-old brother too, who refused extensive walking but reported no muscle pain. Myophosphorylase deficiency was demonstrated by histochemistry and by biochemical analysis of his muscle. The female case illustrates that in children with the clinical picture of inflammatory myopathy and serological but not clinical response to therapy underlying metabolic muscle disorders should be excluded. Since the pathogenesis of polymyositis remains unclear, we speculate that inflammatory changes observed in the muscles may have been initiated by muscular damage resulting from the underlying metabolic disease. The serological changes remained unexplained and may contribute to a so far undeterminable connective tissue disease.

Adolescent↗
PubMed2006

Infectious myositis involving the piriformis in a patient with rheumatoid arthritis.

A 49-year-old Japanese woman treated with oral corticosteroids, methotrexate, and infliximab for malignant rheumatoid arthritis was admitted because of fever and low back pain. The white blood cell count and C-reactive protein concentration were elevated. Lumbar and pelvic computed tomography showed enlargement of the piriformis muscle including a hypodense area consistent with gas formation. The patient was treated successfully for infectious myositis with intravenous antibiotics.

Adrenal Cortex Hormones↗
PubMed2003

Chimerism in myositis.

Bidirectional cell trafficking occurs between a mother and fetus during pregnancy. The trafficking is associated with the persistence of non-self cells. Persistence of these cells has been demonstrated after birth for many years in the child and mother. Children and adults with inflammatory myositis are reported to have persistence of microchimeric cells more often than healthy individuals in their peripheral blood and muscle tissue.

Adult↗
PubMed2004

Influenza-associated myositis in children.

BACKGROUND: Influenza-associated myositis (IAM) is an infrequent and poorly known complication of influenza virus infection in children. The aim of this study was to describe five cases of IAM and to review the literature on IAM in children. PATIENTS AND METHODS: We conducted a retrospective analysis of cases of IAM diagnosed at two university children's hospitals in Switzerland during two consecutive influenza seasons. Findings were compared with 39 individual case reports and five publications summarizing an additional 272 cases identified by a medical online library (MEDLINE) search. RESULTS: Overall, 316 cases were analyzed. IAM typically occurred in school-aged children with a 2:1 male predominance. Influenza B and A viruses were identified in 76% and 24% of cases, respectively. The median interval between onset of influenza and onset of IAM was 3 days (range 0-18). The calf muscles were involved alone or together with other muscle groups in 69% and 31% of cases, respectively. Blood creatine phosphokinase (CPK) concentration was invariably elevated. Median duration to clinical recovery was 3 days (range 1-30). Rhabdomyolysis occurred in ten of 316 patients (3%), was more common in girls (80%), more often associated with influenza A (86%), and led to renal failure in eight patients (80%). CONCLUSION: Clinical and laboratory findings of IAM are highly characteristic and allow a rapid diagnosis during the influenza season.

Age of Onset↗
PubMed1989

Orbital hemorrhage and eyelid ecchymosis in acute orbital myositis.

We examined two patients with acute orbital myositis associated with orbital hemorrhage and eyelid ecchymosis. Both patients were young women (aged 22 and 30 years) who had painful proptosis, diplopia, and computed tomographic evidence of single extraocular muscle involvement with spillover of inflammatory edema into the adjacent orbital fat. Patient 1 showed contralateral preseptal eyelid inflammation and did not suffer an orbital hemorrhage until after an episode of vomiting. In Patient 2, the diagnosis of occult orbital varix was initially considered but an orbital exploration and a biopsy specimen showed no vascular anomaly. Both patients were treated successfully with high-dose systemic corticosteroids. Some cases of idiopathic orbital inflammation may be related to preexisting vascular anomalies or orbital phlebitis.

Acute Disease↗
PubMed1993

Radial nerve injury associated with traumatic myositis ossificans in a brain injured patient.

As unrelated complications, peripheral nerve injury and heterotopic ossification (HO) are frequently observed in brain injured patients. Our case presentation is a 24-year-old man who sustained a brain injury in a motor vehicle accident. At two months postinjury he remained at a Rancho Level II and had HO identified in eight joints. Over the next several months, his cognition improved and he demonstrated active movement at the left wrist, but no movement at the right wrist. Plain radiographs and bone scan were consistent with myositis ossification posterior to the right mid-humerus and no fracture was identified. Electromyography revealed a right radial nerve injury below the branch to the triceps. Nine months postinjury, the patient had 4-/5 strength in right wrist extension. A thorough evaluation of all possible etiologies for a given impairment may lead to altered treatment and/or prognosis.

Adult↗
PubMed1986

Histidyl-tRNA synthetase, the myositis Jo-1 antigen, is cytoplasmic and unassociated with the cytoskeletal framework.

The myositis-specific anti-Jo-1 autoantibody, which is directed against histidyl-tRNA-synthetase, is found in 30% of polymyositis patients. The Jo-1 antigen has been reported to be a nuclear antigen by some authors. On the contrary we show that less than 2% of the total histidyl-tRNA and lysyl-tRNA synthetase activities are associated with purified rat liver nuclei or the hepatocyte intermediate filament-nuclear fraction. In the presence of polyethylene glycol, in which the high Mr multi-enzyme complex containing lysyl-tRNA synthetase is insoluble, 65% of the lysyl-tRNA synthetase and only 15% of histidyl-tRNA synthetase activities remained associated with the cytoskeletal framework. The Jo-1 antigen exhibited a diffuse granular cytoplasmic distribution in cultured rat hepatocytes as determined by indirect immunofluorescent microscopy. Hence, the Jo-1 antigen is cytoplasmic and unassociated with the cytoskeletal framework or high Mr synthetase complex in situ.

Amino Acyl-tRNA Synthetases↗
PubMed1982

Inclusion body myositis. Clinical, biological and ultrastructural study.

A 48-year-old patient presented for the past 4 years an amyotrophy of the quadriceps and moderate involvement of the truncal and pelvic girdle muscles. The CK level was elevated (10 times the normal rate) and the EMG revealed a fibrillation pattern on relaxation, myotonic bursts on needle insertion and reduced activity during contraction. The histological study of the muscle biopsy showed nuclear cytoplasmic inclusion bodies and pseudo-myelinic membranes. The case was classified in the inclusion body myositis group. Analysis of the other published cases underlines the variety of the clinical, biological and electromyographical aspects and abnormalities.

Biopsy↗
PubMed1990

Inclusion body myositis: peripheral nerve involvement. Combined morphological and electrophysiological studies on peripheral nerves.

The occurrence of neuropathy in 5 cases of inclusion body myositis (IBM) was studied. The intramuscular nerve branches showed variable ultrastructural changes in all cases. The observed changes were loss of axons, wallerian degeneration and axon terminal atrophy. EMG with concentric needles showed myopathic motor unit potentials in all cases. A reduced interference pattern due to loss of motor units was found in all cases. All but one patient showed fibrillation potentials in several muscle groups. Motor nerve conduction velocities and F-wave latencies were pathological in two of the cases, in which there were motor unit potentials with increased amplitude and duration as evidence of reinnervation. Sural nerve biopsy in one of these cases revealed slight neuropathy of the axonal type. These findings support the concept of peripheral nerve involvement in many cases of IBM.

Action Potentials↗
PubMed1991

Inclusion body myositis and Welander distal myopathy: a clinical, neurophysiological and morphological comparison.

Five patients with inclusion body myositis (IBM), an acquired inflammatory myopathy, and five patients with Welander hereditary distal myopathy (WDM) were compared clinically and with neurophysiological and morphological techniques. Both diseases have a late insidious onset, but the course of IBM is more severe. IBM mainly affects proximal muscles in the lower extremities, while distal muscle groups are involved in both upper and lower extremities. In WDM there is always a strict distal muscle involvement. The neurophysiological characteristics of the two conditions include both myopathic and neurogenic components. In both diseases there were rimmed vacuoles in muscle fibres and at the ultrastructural level cytoplasmic 15-18 nm filamentous inclusions. Although the histopathology of muscle in IBM and WDM has some common features, inflammatory infiltrates were never found in WDM. Such infiltrates seem to be an important clue to the correct diagnosis of IBM.

Aged↗
PubMed1992

Quantitative morphometric study of muscle in inclusion body myositis.

Clinical and electromyographic findings do not clearly distinguish inclusion body myositis (IBM) from chronic polymyositis (PM). The rimmed vacuoles and filamentous nuclear and cytoplasmic inclusions that characterize IBM are often sparse and may be overlooked; conversely, these features may occasionally be seen in other diseases. Preliminary studies suggested that muscle fiber hypertrophy occurred more frequently in IBM than in PM. To investigate whether fiber hypertrophy can be used to improve the ability to separate IBM from PM, we report a morphometric analysis of 28 IBM cases, 22 PM and 22 dermatomyositis (DM) cases. The analysis, using a computer automated system, included proportion of hypertrophied fibers and also fiber type proportions, average fiber diameter, proportion of atrophic and angulated fibers, and the co-dispersion index (CDI). The proportion of hypertrophied fibers was greater in IBM than the other two conditions (IBM (mean +/- SEM) 31.0 +/- 4.7% and 12.2 +/- 2.4% for type 1 and type 2 fibers, respectively, compared to 9.8 +/- 3.0% and 3.3 +/- 1.7% in PM, and 7.7 +/- 2.7% and 3.9 +/- 1.9% in DM). These differences were statistically significant (P < 0.05) in both sexes for type 1 fibers and in women for type 2 fibers. Also, the average fiber size and hypertrophy factors for type 1 and type 2 fibers were increased in IBM compared to PM and DM. This study confirms that the presence of muscle fiber hypertrophy in biopsies from IBM patients may help differentiate them from other clinically similar inflammatory myopathies.

Dermatomyositis↗