Focal inflammatory myopathy

Lederman, Richard J.; Salanga, Virgilio D.; Wilbourn, Asa J.; Hanson, Maurice R.; Dudley, Alden W.

doi:10.1002/mus.880070210

Cited by 26 publications

(7 citation statements)

References 13 publications

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“…Focal myositis is a rare condition that may be confused clinically with other disorders of muscle in-cluding muscle tumors, localized nodular myositis progressing to polymyositis, or proliferative myositis. 6,11,13,21 In our series of eight patients with FM, we found that clinical characteristics were nearly uniform. Patients frequently presented with a painful mass that developed subacutely within the substance of a single muscle.…”

Section: Discussionmentioning

confidence: 59%

Clinical and pathologic features of focal myositis

et al. 2000

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To clarify the nosology of focal myositis (FM), we report the clinical and pathologic features of eight patients presenting with focal enlargement of one muscle. Most patients improved without immunosuppressive therapy, and none developed polymyositis. Pathologic features were those of an inflammatory myopathy, with muscle fiber hypertrophy and moderate to severe inflammation. In most cases, a clustering of tightly packed muscle fibers, enveloped by a thick bundle of fibrosis, was associated with the diagnosis of FM. Immunohistochemistry showed T cell predominance within the interstitial infiltrates in all cases. No evidence of vasculitis was present. Our findings suggest that FM is a benign condition that has certain clinical features separating it from other inflammatory myopathies. Pathologic changes, such as large clusters of nesting muscle fibers surrounded by thick fibrosis, are more characteristic of FM than polymyositis. © 2000 John Wiley & Sons, Inc. Muscle Nerve 23: 1569–1575, 2000

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Section: Discussionmentioning

confidence: 59%

Clinical and pathologic features of focal myositis

et al. 2000

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“…Systemic symptoms are typically absent and serum muscle enzymes or other routine laboratory investigations are normal. 12,15,17 Computerized tomography reveals a well-circumscribed lesion, isodense with muscle tissue, and T2-weighted MRI shows increased signal intensity within the entire head of the muscle, sometimes with fatty infiltration and inhomogeneous enhancement after contrast. 6,7 These aspects can simulate a soft tissue neoplasm, but the diagnosis of local inflammation is confirmed by biopsy.…”

Section: Discussionmentioning

confidence: 97%

Focal myositis associated with S‐1 radiculopathy: Report of two cases

et al. 2004

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Two cases are described of pseudotumoral calf hypertrophy after laminectomy for a compressive S-1 radiculopathy. The serum creatine kinase (CK) level was normal or mildly elevated. T2-weighted magnetic resonance imaging (MRI) showed calf enlargement, with an increased signal of the medial head of the gastrocnemius muscle. Electromyography revealed fibrillation potentials and positive sharp waves, but no complex repetitive discharges in the affected gastrocnemius muscle, with motor unit potentials having mixed neurogenic and myopathic features. Muscle biopsy revealed a focal myositis associated with some features of denervation. A brief course of corticosteroids was followed by remission clinically and improvement in the MRI findings.

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“…Disfagia, dor e/ou sensibilidade muscular associadas a alterações cutâneas são comuns. Acometimento da musculatura respiratória também pode ser observado 13 . Inexiste critério absolutamente definido para o diagnóstico de polimiosite, a exemplo do que existe para doença reumática (critérios de Jones) e artrite reumatóide (critérios da Associação Americana de Reumatismo).…”

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“…A moléstia em discussão, de forma ocasional, pode ser mais seletiva, mimetizando, por exemplo, a distrofia fascioescapuloumeral 13 .…”

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Associação rara: polimiosite, miastenia grave e timoma

Boekel¹,

Godoy²,

Menezes³

1990

Arq. Neuro-Psiquiatr.

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RESUMO -Fundamentados no fato de que, tanto na literatura nacional quanto na estrangeira, inexiste referência da associação de polimiosite, miastenia grave e timoma em adulto jovem do sexo masculino, os autores se propõem a descrever um caso da citada síndrome. O paciente aqui apresentado teve sua doença iniciada aos 22 anos de idade, atingindo sua expressão clínica máxima 4 anos miais tarde.No estudo em apreço, são enfatizadas as dificuldades no diagnóstico diferencial entre polimiosite e miastenia grave, doenças que, a principio, têm suas manifestações clinicas características, de modo geral bem individualizadas. Na presente observação chamamos a atenção para a possível existência de aspectos clínicos sugestivos de miastenia em enfermos com polimiosite e, por outro lado, alterações histopa¬ tológicas típicas de polimiosite em músculos de miastênicos, inviabilizando muitas vezes o diagnóstico clínico de certeza. An unusual association: polymyositis, myasthenia gravis, and thjmoma.SUMMARY -Based on the inexistence of references in Brazilian and International literature of the association polymyositis, myasthenia gravis and thymoma in a young male adult, the authors propose to describe one case presenting the associated syndrome. The disease began when the patient was 22 years old, being the climax of its clinical expression four years later.It is emphasyzed the difficulty on the differential diagnosis between polymyositis and myasthenia gravis, once these diseases frequently have their clinical manifestations well individualized.In this study we call attention to the existence of clinical aspects of myasthenia gravis in patients presenting polymyositis and, on the other hand, histopatho¬ logical alterations typical of polymyositis in myasthenic muscles, what makes the clinical diagnosis uncertain many times.Polimiosite e miastenia grave são consideradas doenças «desimunes», provavelmente relacionadas a «discrasia linfocítica», termo utilizado por Engel et al. 9 .Existem, no momento, diversas evidências indicativas de semelhanças entre as duas enfermidades. Publicações ocasionais têm descrito pacientes com aspectos clínicos e patológicos tanto de polimiosite quanto de miastenia, de forma concomitante 21 .A situação complica-se ainda mais quando, em 1955, Stortebecker et al., citados por Paterson e ChurchillDavidson 20 descreveram alterações histológicas em músculos de enfermos com miastenia grave aparentemente não complicada, alterações estas indistinguíveis daquelas observadas na polimiosite e doenças correlatas.Ambas parecem ter patogênese autoimune, ocorrendo com elevada freqüência em associação com outras de mesma natureza.Nas duas moléstias em questão, existe desequilíbrio de antígenos de histocompatibilidade: HLA B8 e HLA DR3, além de boa resposta ao uso de agentes imunos-

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Focal inflammatory myopathy

Cited by 26 publications

References 13 publications

Clinical and pathologic features of focal myositis

Clinical and pathologic features of focal myositis

Focal myositis associated with S‐1 radiculopathy: Report of two cases

Associação rara: polimiosite, miastenia grave e timoma

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