Myonecrosis of Behcet’s disease

Abstract

Behcet's disease is an inflammatory disease of unknown cause characterized by intermittent episodes of acute inflammation manifested by oral aphthous ulcers, genital ulcers, uveitis, and skin lesions. We report a rare case of myonecrosis associated with Behcet's disease. Myonecrosis of Behcet's disease can mimic soft tissue abscess and therefore awareness of this entity in the appropriate clinical setting is important for initiation of appropriate and timely treatment.

Behçet disease‐associated rhabdomyolysis treated with infliximab

“…Rarely, cases of locally acquired hepatitis E have been reported in Queensland. 5 This is the first published locally acquired case of HEV in Queensland. The negative serology in this case highlights the need to use HEV RNA as the first line test in immunocompromised patients.…”

“…Treatment of BDassociated myositis has been described with colchicine, corticosteroids, cyclosporine and cyclophosphamide. 1,2,4,5 TNF-inhibitors are recommended in severe or refractory BD. 6 However, there are no reported cases of incomplete response to corticosteroid therapy or the use of TNF-inhibitors in BD-associated myositis.…”

“…As the risk of person-to-person transmission of HEV remains undefined and immunocompromised patients may shed the virus for longer 4,5 an Expert Advisory Group was convened to assist with public health management. The group recommended serial serum HEV RT-rPCR testing to determine response to ribavarin, period of viraemia and likely infectiousness ( Table 1).…”

Histopathology of the muscle in rheumatic diseases

“…In BD it is usually represented by focal skeletal muscle involvement, (75,78) but orbital involvement has also been described (79,80). The muscular biopsy in BD samples typically exhibits perivasculitis (81,82) or necrotizing vasculitis (83), with muscular inflammation presenting as myositis and necrotic foci (76,81,84,85), sometimes with a nodular aspect (84). The cellular infiltrates may be characterized prominently by the presence of granulocytes and monocytes or lymphocytes and monocytes (76).…”

“…The muscular biopsy in BD samples typi cally exhibits perivasculitis(81,82) orN o n -c o m m e r c i a l cally exhibits perivasculitis (81, 82) or necrotizing vasculitis (83), with muscular N o n -c o m m e r c i a l necrotizing vasculitis (83), with muscular inflammation presenting as myositis and N o n -c o m m e r c i a l inflammation presenting as myositis and necrotic foci (76, 81, 84, 85), sometimes N o n -c o m m e r c i a l necrotic foci (76, 81, 84, 85), sometimes u s e mon muscle manifestation is myositis (75, u s e mon muscle manifestation is myositis (75, 76). Although imaging may be helpful in u s e 76).…”