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Query: UMLS:C0027121 (myositis)
 4,538 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Orbital myositis is an uncommon subgroup of the nonspecific orbital inflammatory syndromes (previously termed orbital pseudotumor) and presents with eyelid swelling and redness, conjunctival chemosis, pain, proptosis, and diplopia. The disease is to date of unknown origin; autoimmune processes are suspected for the etiology. In the case of an otherwise healthy young male patient (age 28 years), the coexistence of chronic sinusitis primarily led to the diagnosis of sinugen orbital cellulitis. Despite antibiotic drug administration and surgical drainage of the paranasal sinuses the symptoms persisted. A second computed tomography revealed fusiform, inflammatory enlargement of the m. rectus lateralis. This muscle showed a restrictive paresis so that initially the m. rectus medialis was suspected to be paretic. The patient responded dramatically to administration of prednisolone within 2 days. The differential diagnosis between a sinugen orbital complication and orbital myositis is significant because corticosteroids are contraindicated for orbital cellulitis whereas they remain the therapy of choice for orbital myositis.
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PMID:[Ocular myositis. A rare differential diagnosis of sinus-induced orbital complications]. 1154 88

We report a 62-year old woman with orbital myositis who had a favorable response to intravenous immunoglobulin (i.v.-IG) administration in preventing disease recurrence. She had been suffering from frequent relapses of swelling and redness of the left eye with increasing pain and diplopia caused by restricted eye movement of the left eyeball. T2-weighted magnetic resonance image of the orbit showed enlargement of the left medial rectus muscle. She was treated with 1 g of methylprednisolone per day for 3 days. One mg/kg per day of oral prednisolone was subsequently started with non-steroid anti-inflammatory drugs, which resulted in improvement. However, her symptoms were aggravated while the drug was tapered off even though she used a high dose of oral prednisolone. High dose of i.v.-IG (400 mg/kg per day) was then administered for five days. Since the treatment, she has been free from recurrences of the disease for over one year, suggesting that i.v.-IG can prevent the recurrence of orbital myositis. Some reports have suggested that i.v.-IG treatment is useful to prevent recurrence of other forms of inflammatory myositis, such as dermatomyositis or polymositis. Overproduction of the pro-inflammatory cytokines (IL-1, IL-1 beta, INF-alpha) and Th1 cytokines (INF-gamma, IL-2) are related to the deterioration of these diseases. I.v.-IG treatment suppresses the production of the pro-inflammatory cytokines. In our case, serum levels of the pro-inflammatory cytokines were all normal, but the IL-4 level was elevated after the i.v.-IG treatment, suggesting that orbital myositis was probably related to the Th1 dominant disease that was suppressed by IL-4.
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PMID:[A patient of recurrent orbital myositis with good response to high-dose intravenous immunoglobulin (i.v.-i.g.) therapy]. 1242 67

Idiopathic giant cell myocarditis is a rare and frequently fatal inflammatory heart disease which leads to congestive heart failure or ventricular arrhythmias. It is often associated with other autoimmune disorders. We report a 39-year-old woman who first presented with diplopia and painful eye movements, the typical clinical picture of orbital myositis. Shortly afterwards, she developed rapidly progressive congestive heart failure due to giant cell myocarditis, which took a fatal course within some weeks. Autopsy confirmed both disorders. This case report underlines the importance of early and repeated monitoring of cardiac function, if orbital myositis is suspected, in order to consider cardiac transplantation, the only efficacious treatment of giant cell myocarditis, in time.
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PMID:[Diplopia and cardiogenic shock]. 1590 79

The authors report a patient who was diagnosed with idiopathic orbital myositis based on the findings of diplopia, worse on right gaze, globe retraction on adduction and injection at the lateral muscle tendon insertion of the left eye. Although orbital myositis as a cause of acquired retraction of the eye is rare, they wish to emphasize the importance of globe retraction with injection over the recti as an important clue for the diagnosis of orbital myositis.
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PMID:Acquired retraction of the eye as the first sign of myositis. 1602 Mar 63

We report a rare case of a 32-year-old Caucasian man who presented with a 2-month history of progressive proptosis in his left eye with no visual impairment nor diplopia. He had suffered from ulcerative colitis for 3 years before presentation. Computed tomography and magnetic resonance imaging scans demonstrated mild proptosis and isolated enlargement of the left superior rectus muscle. Laboratory examination results showed no evidence of other ocular or systemic disease. He was treated with a short course of systemic steroids. His intestinal and eye conditions quickly improved over the following weeks. After a 1-year follow up, the orbital myositis remains unchanged and the digestive condition is satisfactory with a long-term mesalazine therapy. To our knowledge fewer than 10 cases of orbital myositis associated with ulcerative colitis have been reported in the literature. We present and discuss a new case with a concomitant evolution between these two disorders.
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PMID:[Orbital myositis associated with ulcerative colitis]. 1614 24

We reported two patients of orbital myositis with abnormal accumulation of 6 Ga in the bilateral orbits. The first patient, a 34-year-old man, developed bilateral lid swelling and external ophthalmoplegia. T1-weighted MRI of the bilateral orbits showed enlargement of the bilateral extraocular muscles. 67Ga scintigraphy also showed abnormal accumulation in the orbits. The second patient, a 64-year-old woman, developed diplopia caused by restricted abduction of the bilateral eyes. 67Ga scintigraphy showed abnormal accumulation in the bilateral orbits, in spite of no finding in the MRI of the extraocular muscles. Both cases were treated with 1 g of methylprednisolone per day for 3 days and subsequently 1 mg/kg per day of oral prednisolone, which resulted in improvement of opthalmoplegia and disappearance of the abnormal accumulation of 67Ga in the orbits. There is no report about orbital myositis with abnormal accumulation of 67Ga in the orbit. Our cases suggest that 67Ga shows the activity of orbital myositis and can be useful for diagnosis, especially in case of no abnormality in MRI study.
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PMID:[Two cases of orbital myositis with 67Ga accumulation in the orbits]. 1654 96

The diagnosis of mitochondrial myopathy depends upon a constellation of findings, family history, type of muscle involvement, specific laboratory abnormalities, and the results of histological, pathobiochemical and genetic analysis. In the present paper, the authors describe the diagnostic approach to mitochondrial myopathies manifesting as extraocular muscle disease. The most common ocular manifestation of mitochondrial myopathy is progressive external ophthalmoplegia (PEO). To exclude myasthenia gravis, ocular myositis, thyroid associated orbitopathy, oculopharyngeal muscular dystrophy, and congenital fibrosis of the extraocular muscles in patients with an early onset or long-lasting very slowly progressive ptosis and external ophthalmoplegia, almost without any diplopia, and normal to mildly elevated serum creatine kinase and lactate, electromyography, nerve conduction studies and MRI of the orbits should be performed. A PEO phenotype forces one to look comprehensively for other multisystemic mitochondrial features (e.g., exercise induced weakness, encephalopathy, polyneuropathy, diabetes, heart disease). Thereafter, and presently even in familiar PEO, a diagnostic muscle biopsy should be taken. Histological and ultrastructural hallmarks are mitochondrial proliferations and structural abnormalities, lipid storage, ragged-red fibers, or cytochrome-C negative myofibers. In addition, Southern blotting may reveal the common deletion, or molecular analysis may verify specific mutations of distinct mitochondrial or nuclear genes.
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PMID:Extraocular mitochondrial myopathies and their differential diagnoses. 1676 Jan 17

A 47-year-old man presented with complaints of progressive diplopia in downgaze and a painful firm mass on the left medial superior canthus. On examination, there was marked hyperemia of the superior bulbar conjunctiva of the left eye. Systemic examination revealed erythematous papules on his trunk and pulmonary infiltrates. CT of the orbits revealed a fusiform enlargement of the left superior oblique muscle and diffuse infiltration of the left temporal region. Biopsy of the left superior oblique muscle and temporal muscle disclosed Congo red deposits that show apple-green birefringence under polarized light. A comprehensive systemic investigation failed to show any disease that could explain the amyloid deposits. The patient was then diagnosed as having primary systemic amyloidosis. We think that this case highlights the necessity of a biopsy in any atypical extraocular muscle enlargement before a diagnosis of myositis.
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PMID:Superior oblique muscle amyloidosis mimicking myositis. 1820 59

A 66-year-old female presented with a 6-month history of increasing right-sided facial pain and diplopia. Right ocular movements were restricted in adduction and downgaze. Superior oblique (SO) enlargement was seen on an initial MRI scan, and subsequent diffuse infiltration was seen on a repeat scan. An elevated cANCA and biopsy of SO confirmed Wegener's granulomatosis (WG). We report a case of SO myositis as a predominant early feature of WG granulomatosis and review the literature regarding extraocular muscle involvement in WG. To our knowledge, early SO involvement has not been reported.
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PMID:Superior oblique myositis as an early feature of orbital Wegener's granulomatosis. 1856 30

Orbital myositis is an inflammatory process that primarily involves the extraocular muscles and most commonly affects young adults in the third decade of life, with a female predilection. Clinical characteristics of orbital myositis include orbital and periorbital pain, ocular movement impairment, diplopia, proptosis, swollen eyelids, and conjunctival hyperemia. The most common presentation is acute and unilateral, which initially responds to systemic corticosteroid therapy. However, chronic and recurrent cases may involve both orbits. Many inflammatory, vascular, neoplastic, and infectious conditions that affect the extraocular muscles and other orbital tissue can mimic orbital myositis. The most important differential diagnoses include thyroid-related eye disease, other orbital inflammatory processes (unspecific idiopathic inflammation, vasculitis, and sarcoidosis), orbital cellulitis, and orbital tumors. In refractory, chronic, or recurrent cases, steroid-sparing agents, inmmunosuppressants, or radiation therapy may be indicated.
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PMID:Orbital myositis: diagnosis and management. 1965 80


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