1/44. First report of tropical myositis and crescentic glomerulonephritis in a renal transplant recipient.We describe a renal transplant recipient who presented with tropical myositis and acute allograft dysfunction 2(1/2) years after transplantation. Graft biopsy showed immune-complex crescentic glomerulonephritis. He was receiving only 7.5 mg/d of prednisolone for more than 2 months before presentation. Renal function did not improve despite treatment with antibiotics, methylprednisolone pulse therapy, and cyclophosphamide. He died of septicemia.- - - - - - - - - - ranking = 1keywords = complex (Clic here for more details about this article) |
2/44. hepatitis c virus infection and myositis: a polymerase chain reaction study.Muscle biopsy tissue from a patient with chronic hepatitis, who was hepatitis c virus (HCV) positive and showed slight weakness of the right arm and leg associated with increased serum creatine kinase levels, was studied using immunocytochemical and polymerase chain reaction (PCR) techniques. Muscle biopsy showed changes compatible with an inflammatory myopathy. Immunohistochemical studies included the use of monoclonal antibodies against human T lymphocytes, macrophages, immunoglobulins, major histocompatibility complex class I molecules (MHC-I), and the neoantigens of the terminal C5b-9 complement membrane attack complex (MAC). In addition to confirming the potential importance of cytotoxic T cells and MHC-I antigen expression in inducing muscle pathology, we demonstrated MAC deposition and the presence of HCV-rna in the muscle of our patient, suggesting that direct involvement of the virus leading to complement activation might be important in inducing muscle damage.- - - - - - - - - - ranking = 2keywords = complex (Clic here for more details about this article) |
3/44. Glycogenosis type V (McArdle's disease) mimicking atypical myositis.A 13-year-old girl was referred to our clinic because of a positive rheumatoid factor test, muscle pain and weakness. Laboratory evaluation revealed an increased ESR, hypergammaglobulinaemia, antinuclear antibodies, circulating immune complexes, complement consumption and elevated serum creatine kinase (CK) activity. A needle biopsy of the dolent muscle showed normal routine histology. immunohistochemistry disclosed single lymphocytes and a weak myocytic HLA class I expression. The diagnosis of myositis was considered and corticosteroids were initiated, leading to an increase of complement levels and a decrease of CK-activity and ESR. She subjectively felt stronger but still reported exercise intolerance and metabolic myopathy was considered. Myophosphorylase activity was completely lacking, establishing the diagnosis of McArdle's disease. CK level was found to be elevated in an obese 4-year-old brother too, who refused extensive walking but reported no muscle pain. Myophosphorylase deficiency was demonstrated by histochemistry and by biochemical analysis of his muscle. The female case illustrates that in children with the clinical picture of inflammatory myopathy and serological but not clinical response to therapy underlying metabolic muscle disorders should be excluded. Since the pathogenesis of polymyositis remains unclear, we speculate that inflammatory changes observed in the muscles may have been initiated by muscular damage resulting from the underlying metabolic disease. The serological changes remained unexplained and may contribute to a so far undeterminable connective tissue disease.- - - - - - - - - - ranking = 1keywords = complex (Clic here for more details about this article) |
4/44. Inflammatory myositis: a rare differential diagnosis of a neck lump.Inflammatory myositis is an extremely rare benign inflammatory condition of skeletal muscle. It usually affects the extremities, and there are only 10 cases reported in the head and neck region. Its significance is that in this region it can be clinically mistaken for a neoplasm. We describe a case and review the literature.- - - - - - - - - - ranking = 1.1972019759705keywords = neoplasm (Clic here for more details about this article) |
5/44. Myopathy with antibodies to the signal recognition particle: clinical and pathological features.OBJECTIVES: To study myopathies with serum antibodies to the signal recognition particle (SRP), an unusual, myositis specific antibody associated syndrome that has not been well characterised pathologically. methods: Clinical, laboratory, and myopathological features were evaluated in seven consecutive patients with a myopathy and serum anti-SRP antibodies, identified over three years. The anti-SRP myopathy was compared with myopathology in other types of inflammatory and immune myopathies. RESULTS: The patients with anti-SRP antibodies developed weakness at ages ranging from 32 to 70 years. Onset was seasonal (August to January). Weakness became severe and disability developed rapidly over a period of months. Muscle pain and fatigue were present in some patients. No patient had a dermatomyositis-like rash. serum creatine kinase was very high (3000 to 25 000 IU/l). Muscle biopsies showed an active myopathy, including muscle fibre necrosis and regeneration. There was prominent endomysial fibrosis, but little or no inflammation. Endomysial capillaries were enlarged, reduced in number, and associated with deposits of the terminal components of complement (C5b-9, membrane attack complex). Strength improved in several patients after corticosteroid treatment. CONCLUSIONS: Myopathies associated with anti-SRP antibodies may produce severe and rapidly progressive weakness and disability. Muscle biopsies show active myopathy with pathological changes in endomysial capillaries but little inflammation. Corticosteroid treatment early in the course of the illness is often followed by improvement in strength. In patients with rapidly progressive myopathies and a high serum creatine kinase but little inflammation on muscle biopsy, measurement of anti-SRP antibodies and pathological examination of muscle, including evaluation of endomysial capillaries, may provide useful information on diagnosis and treatment.- - - - - - - - - - ranking = 1keywords = complex (Clic here for more details about this article) |
6/44. A muscular lesion suggestive of focal myositis in a child with proteus syndrome.proteus syndrome is a polymorphic hamartomatous disorder associated with a broad spectrum of rare congenital malformations. Many neoplasms have been linked to this condition, including lipomas, lymphangiomas, and hemangiomas. The authors describe a case of a congenital muscular lesion in a child with proteus syndrome. This mass was painless but was growing out of proportion to her leg musculature. A magnetic resonance imaging scan and incisional biopsy showed findings consistent with focal myositis. The clinical, radiographic, and histologic characteristics of this previously undescribed lesion are discussed, with a brief review of the literature.- - - - - - - - - - ranking = 1.1972019759705keywords = neoplasm (Clic here for more details about this article) |
7/44. hepatitis c virus infection and myositis: a virus localization study.We report a case of myositis associated with chronic hepatitis c virus infection. Muscle biopsy and immunohistochemistry showed perifascicular atrophy, few necrotic and regenerating fibres, scarce perivascular infiltrates, deposits of immunoglobulin g, C3, fibrinogen and MAC in muscle vessel walls, and non-uniform expression of major histocompatibility complex-I antigens among muscle fibres. hepatitis c virus NS3 antigen and hepatitis c virus rna were detected in infiltrating cells but not within muscle fibres or endothelial cells. Our findings suggest that humoral-mediated immune mechanisms, not directly related to hepatitis c virus infection of muscle structures, may sustain the local inflammatory reaction in this patient.- - - - - - - - - - ranking = 1keywords = complex (Clic here for more details about this article) |
8/44. polymyositis in Kaposi syndrome.polymyositis in association with Kaposi sarcoma occurred in a 60-year-old black man. Muscle biopsy revealed prominent plasmacytic and eosinophic inflammatory infiltration resembling the myopathy of sjogren's syndrome. Nonspecific changes were seen by electron microscopy of post mortem muscle. The myopathy could be interpreted as a remote effect of neoplasm.- - - - - - - - - - ranking = 1.1972019759705keywords = neoplasm (Clic here for more details about this article) |
9/44. Lepromatous leprosy presenting with polyarthritis, myositis, and immune-complex glomerulonephritis.A Pakistani man aged 19 years was admitted to a rheumatological unit in the United Kingdom with acute widespread polyarthritis accompanied by night sweats and fever. Preliminary examination suggested Reiter's disease, but further investigation showed acute glomerulonephritis with uraemia. The possibility of periarteritis nodosa, and the prominence of muscle tenderness in the legs, led to biopsies of striated muscle and skin, in both of which were changes typical of lepromatous leprosy, with many mycobacterium leprae on Ziehl-Neelsen staining. serum showed IgG-IgM cryoglobulinaemia without antiglobulin activity, and in the recovery phase renal biopsy showed a resolving proliferative glomerulonephritis with linear IgG and IgM immunofluorescence and granular deposits of C3. Clinical signs subsided rapidly under steroid treatment and subsequent progress on anti-leprosy drugs was uneventful. The term erythema nodosum leprosum is inadequate and misleading as a title for a common and important immune-complex reaction of lepromatous leprosy, in which numerous body systems may be involved.- - - - - - - - - - ranking = 5keywords = complex (Clic here for more details about this article) |
10/44. Immune complex nephropathy in mixed connective tissue disease.Initial reports on the clinical spectrum of mixed connective tissue disease (MCTD) indicated that renal involvement was uncommon. Four of 20 patients with MCTD underwent renal biopsy and all showed evidence of immune complex trapping with a membranous glomerulonephritis in three patients. Clinically evident renal disease was absent in two patients. These findings suggest that renal involvement in MCTD may be more prevalent than previously indicated.- - - - - - - - - - ranking = 5keywords = complex (Clic here for more details about this article) |
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