MRI myositis sine myositis: the importance of the histopathology

Andrés, Mariano; Sivera, Francisca; Alonso, Sonia; Pack, Christopher

doi:10.1093/rheumatology/keu370

Cited by 5 publications

(1 citation statement)

References 2 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…4 MPAN cases frequently exhibit symptoms such as muscular pain and swelling in the lower limbs, including the calves; the CK level was increased in one case, which improved easily with steroid therapy. [4][5][6][7] In our case, skin biopsies of the new purpura were performed, and histopathological testing revealed fibrinoid degeneration of medium-sized arterioles in subcutaneous adipose tissue, confirming the diagnosis of necrotizing angiitis. Histopathological examination of the tibialis anterior muscle showed degeneration with neutrophil and lymphocyte infiltration, and the arteries, the walls of which had degenerated under adipose tissue and above the muscle in the amputated lower limb (Figure 2).…”

Section: Muscular Polyarteritis Nodosa (Mpan) Is a Concept Proposed Bysupporting

confidence: 60%

Cutaneous arteritis with compartment syndrome: Case report and review of published works

Yoshida

Muto

Utsunomiya

et al. 2021

J Cutaneous Imm & Allergy

View full text Add to dashboard Cite

Polyarteritis nodosa (PAN) refers to systemic necrotizing arteritis of small-to medium-sized muscular arteries. Cutaneous PAN is often referred to as Cutaneous arteritis (CA) since 2012, and CA is assumed to affect only the skin, but CA is occasionally associated with neuropathy and muscular disorders. [1][2][3] Here, we report a case of CA with muscle disorders accompanied by skin lesions on the limbs and muscular damage in the right lower limb, along with a review of the relevant literature. | C A S E REP ORTA 76-year-old Japanese man developed joint pain in all limbs and general fatigue about 1 month before his initial consultation to our department. On initial examination, the patient was lucid, his temperature was elevated to 37.9°C, his SpO 2 was 96% (room air), his blood pressure was 106/69 mmHg, and he showed tachycardia (heart rate 120 bpm).Blood analysis showed an elevated white blood cell count (26,100/μl; reference: 3900-9800), C-reactive protein (CRP) level (42.36 mg/dl; reference: 0-0.2), procalcitonin (PCT) level (50.910 ng/ml; reference: <0.5), and creatinine kinase (CK) level (4271 IU/L; reference: 45-226).The bilateral lower limbs exhibited redness, swelling, warmth, and purpura, which were significant on the right side. Furthermore, purpura with red halos was observed on the fingers, toes, and dorsum of the foot (Figure 1A,B). Contrast-enhanced computed tomography (CT) revealed no significant findings in the thoracoabdominal region but showed swelling of the right leg extensor muscle group, slight fluid retention between the superficial posterior and deep posterior compartments, and an elevated subcutaneous fatty tissue concentration (Figure 1C). However, no clear gas, abscess, intra-arterial thrombi or contrast enhancement of branching vessels were observed. Severe tension was observed in the right lower limb. The internal pressures of the right lower limb compartments were measured. The pressure of the anterior compartment was 40 mmHg and that of the superficial

show abstract

Section: Muscular Polyarteritis Nodosa (Mpan) Is a Concept Proposed Bysupporting

confidence: 60%

Cutaneous arteritis with compartment syndrome: Case report and review of published works

Yoshida

Muto

Utsunomiya

et al. 2021

J Cutaneous Imm & Allergy

View full text Add to dashboard Cite

show abstract

Muscular vasculitis confined to lower limbs: description of two case reports and a review of the literature

et al. 2017

View full text Add to dashboard Cite

Muscular involvement is common during systemic vasculitides, such as polyarteritis nodosa. However, in rare cases, muscular involvement can be the only clinically evident feature of the disease. The clinical pattern of isolated muscular vasculitis may mimic several other inflammatory muscle disorders, such as idiopathic inflammatory myositis, and may represent a challenge in differential diagnosis. Herewith, we present two clinical cases as examples of peculiar clinical and histopathological characteristics of isolated muscular vasculitis. Our patients were successfully treated with steroids and immunosuppressive agents. Moreover, we provide a review of the recent existing medical literature. Our cases suggest the importance of performing muscle biopsy in patients with muscular symptoms to guide the diagnosis and the treatment.

show abstract