Childhood macrophagic myofasciitis—consanguinity and clinicopathological features

Childhood macrophagic myofasciitis: A series from the Indian subcontinent

“…Guis et al demonstrated an association of HLA–DRB1*01 with MMF, indicating that a genetic predisposition may be required to develop MMF following exposure to aluminum‐containing vaccines . This was further supported by identification of familial MMF in a mother and son, and a report of MMF in 5 children born of consanguineous marriages . Of interest, patient 1 in our series had consanguineous parents.…”

Macrophagic Myofasciitis Plus (Distinct Types of Muscular Dystrophy)

“…Since vaccination with aluminium-containing vaccines, most often against hepatitis, but also tetanus, is not confi ned to adults but is increasingly applied in children, reports on MMF in children have accrued in recent times most often from outside France, i. e., six originating from Israel [15] , one from Italy [4] , one from France [1] , eight from the Middle East [5,11,18] , seven from Spain [17] , two from the United Kingdom [3] , one from Germany [5] , three from Brazil [10] and eight from the United States of America [9,12,13,19] . Carefully reading these individual descriptions discloses that few if any additional and then largely though not exclusively [11,13] non-specifi c, myopathological fi ndings have been reported in biopsy specimens containing the MMF lesion.…”

Neuromuscular complications of hepatitis A virus infection and vaccines

“…HAV vaccine has been associated with the macrophagic myofasciitis (MMF) syndrome, a novel inflammatory myopathy reported in adults [96] and children [97][98][99]. MMF has been ascribed to an ongoing local immune reaction to aluminum hydroxide [95], added as an adjuvant/booster to the formulation of many human, including HAV, vaccines [100].…”

“…In a series of 50 patients with MMF, 19% had received HAV vaccine at a median of 36 months before the biopsy [100]. MMF manifests as a steroid-responsive arthromyalgia with chronic fatigue [97,101] and, rarely, with central nervous system demyelination [102] that have been difficult to correlate with MMF local pathology [103]. Deltoid muscle injection site histology shows granular periodic acid-Schiff reagent positive macrophage infiltration intermingled with lymphocytes; macrophages may show intracytoplasmic inclusions containing aluminum hydroxide crystals [100].…”