The spectrum of eosinophilic myositis

Kaufman, Lee D.; Kephart, Gail M.; Seidman, Roberta; Buhner, David; Qvarfordt, Ingemar; Nässberger, Lennart; Gleich, Gerald J.

doi:10.1002/art.1780360720

Cited by 56 publications

(34 citation statements)

References 43 publications

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“…This clustering of illnesses makes it extremely unlikely that their symptoms were caused by one of the rare, noninfectious causes of eosinophilia and myositis such as hypereosinophilic syndrome, relapsing eosinophilic perimyositis, periarteritis nodosa, or eosinophilic fasciitis (Shulman's Syndrome). 18 Our cases resemble the eosinophilia-myalgia syndrome due to L-tryptophan ingestion, but our patients denied taking this agent. 19 A growing body of evidence suggests that Sarcocystis muscle infection can be associated with significant disease.…”

Section: Discussionmentioning

confidence: 63%

An outbreak of acute eosinophilic myositis attributed to human Sarcocystis parasitism.

Arness

Brown²,

Dubey³

et al. 1999

The American Journal of Tropical Medicine and Hygiene

105

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Abstract. Seven members of a 15-man U.S. military team that had operated in rural Malaysia developed an acute illness consisting of fever, myalgias, bronchospasm, fleeting pruritic rashes, transient lymphadenopathy, and subcutaneous nodules associated with eosinophilia, elevated erythrocyte sedimentation rate, and elevated levels of muscle creatinine kinase. Sarcocysts of an unidentified Sarcocystis species were found in skeletal muscle biopsies of the index case. Albendazole ameliorated symptoms in the index case; however, his symptoms persisted for more than 5 years. Symptoms in 5 other men were mild to moderate and self-limited, and 1 team member with laboratory abnormalities was asymptomatic. Of 8 team members tested for antibody to Sarcocystis, 6 were positive; of 4 with the eosinophilic myositis syndrome who were tested, all were positive. We attribute this outbreak of eosinophilic myositis to accidental tissue parasitism by Sarcocystis.Human muscular sarcocystosis (syn. sarcosporidiosis) is a rare infection caused by coccidian parasites in the family Sarcocystidae. More than 100 different species of Sarcocystis occur worldwide in a wide range of domestic and wild animal reservoirs, with reported prevalences varying between 10% and 100% in domestic livestock.

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Section: Discussionmentioning

confidence: 63%

An outbreak of acute eosinophilic myositis attributed to human Sarcocystis parasitism.

Arness

Brown²,

Dubey³

et al. 1999

The American Journal of Tropical Medicine and Hygiene

105

View full text Add to dashboard Cite

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“…Typically there is evidence of peripheral blood eosinophilia, in addition to the features of myositis, such as abnormal electromyography and raised creatinine phosphokinase levels. In eosinophilic polymyositis, diffuse and deep infiltration of eosinophils into muscle occurs, with pronounced perivenular eosinophilic cuffing [3,4]. In contrast to focal eosinophilic myositis, muscle fibre invasion is not common but necrosis may occur in areas of dense infiltration [6].…”

Section: Discussionmentioning

confidence: 99%

“…The pathogenesis of eosinophilic myopathy remains undefined. It is possible that, following an unknown triggering event such as trauma, ethanol ingestion, or exposure to some other agent, there is an increase in eosinophil production and activation mediated by cytokines known to be important for the growth and maturation of eosinophils [3]. Pathologic studies of focal eosinophilic myositis have revealed fibre size variation, angular fibres, hypertrophy, fibre splitting and interstitial fibrosis, which are less common findings in polymyositis and are different from the histopathologic changes of eosinophilic myosites.…”

Section: Discussionmentioning

confidence: 99%

“…These include both local and multisystem diseases, with a variable expression of either direct eosinophilotoxic or vasculitic tissue damage and endstage fibrosis [2]. Although EM is well described in the literature of veterinary medicine, there are only scattered reports of these lesions in humans [3]. We report the case of a patient who exhibited tender muscle swelling followed by proximal weakness, peripheral blood eosinophilia and creatinine kinase elevation.…”

Section: Introductionmentioning

confidence: 97%

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Focal Eosinophilic Myositis

et al. 2001

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Idiopathic hypereosinophilic syndrome (HES) is a heterogeneous group of disorders with the common features of prolonged eosinophilia of underdetermined cause and multiple organ system dysfunction. Focal eosinophilic myositis is an uncommon manifestation of HES. We report a case of focal eosinophilic myositis with tender muscle swelling followed by proximal weakness, but without non-systemic symptoms and muscle trophism in the lower limbs. Muscle biopsy specimen showed acute myositis with eosinophil infiltration. Electromyographic features were typical of myositis. The clinical and biochemical response to corticosteroids was excellent, and a relapse that occurred because the steroid dose was not lowered, responded well.

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“…Furthermore, eosinophil degranulation, as evidenced by extracellular MBP deposition, is present in diseases involving numerous organs of the body [5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25]. Using eosinophil granule MBP as a marker of eosinophil infiltration and degranulation, we have examined numerous diseased tissues for the presence of cytotoxic MBP by immunofluorescence, using corresponding normal tissue specimens as negative controls.…”

Section: Introductionmentioning

confidence: 99%

Eosinophil Infiltration and Degranulation in Normal Human Tissues: Evidence for Eosinophil Degranulation in Normal Gastrointestinal Tract

Katô

Kephart

Morikawa

et al. 2001

Int Arch Allergy Immunol

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Eosinophils play an important role in the pathogenesis of inflammatory diseases such as bronchial asthma and host immunity to parasitic infections. Deposition of eosinophil granule proteins and concomitant tissue damage have been documented in various diseases. Here, we review and summarize results of our immunofluorescence studies of eosinophil infiltration and degranulation in various normal human tissues. Furthermore, because eosinophil infiltration and degranulation are not normally present in healthy tissues, we examine whether eosinophil infiltration and degranulation normally occur in the small intestine and whether tissue procurement methods affect the extent of eosinophil infiltration and degranulation there. Hematopoietic and lymphatic tissues, including the thymus, showed eosinophil infiltration, but the only organ showing remarkable eosinophil infiltration and degranulation was the gastrointestinal (GI) tract. Eosinophil degranulation was significantly increased in specimens obtained by endoscopic forceps compared to those obtained by scalpel. These results suggest that tissue procurement methods affect the degree of eosinophil degranulation in the GI tract and that, among normal human body organs, both eosinophil infiltration and degranulation only occur in the GI tract.

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The spectrum of eosinophilic myositis

Cited by 56 publications

References 43 publications

An outbreak of acute eosinophilic myositis attributed to human Sarcocystis parasitism.

An outbreak of acute eosinophilic myositis attributed to human Sarcocystis parasitism.

Focal Eosinophilic Myositis

Eosinophil Infiltration and Degranulation in Normal Human Tissues: Evidence for Eosinophil Degranulation in Normal Gastrointestinal Tract

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