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

Two cases of mainly interstitial myositis with epitheloid and giant cells are reported. In the first case, the late amyotrophic-type paralysis of the two girdles, of the clinical myositis type, was associated with severe myocardial damage, the atrioventricular conduction disorder requiring a pace-maker. This observation would appear to be a true polymyositis of the collagen diseases, in view of the associated skin affection, death occurring within a year, a large increase in serum muscle enzymes and urine creatine, the existence of a rheumatoid factor and striated muscle antibodies, and a large increase in M and G immunoglobulins. In the 2nd case, the amyotrophic affection of the pelvic girdle was associated with progressive blindness, diabetes insipidus, and anterior pituitary insufficiency. Death occurred after two years and autopsy showed a suprasellar dysgerminoma (ectopic pinealoma) without any visceral localization of sarcoidosis. The authors discuss the concept of granulomatous polymyositis, autonomous with respect to the sarcoidosis, and sometimes symptomatic of an inflammatory connective tissue condition or a malignant tumor.
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PMID:[Granulomatous myositis during collagenosis (one case) and suprasellar dysgerminoma (one case) (author's transl)]. 48 59

A 25-year-old woman with a 2 years history of painful enlargement of the left calf visited our clinic because of ache in the left calf which became severe enough to interfere her walk. She had no history of trauma to the calf, and family history was negative for muscle disease. Physical examination showed an enlarged left calf muscle with pain which was evoked by stretching of the Achilles tendon. There was no muscle weakness or neurological abnormality. Laboratory tests were all within normal limits, including erythrocyte sedimentation rate and serum enzymes such as creatine kinase and aldolase. The CT scan revealed an isolated round-shaped low density area in the left calf muscle, which showed up as a markedly high signal intensity on T2 weighted images of MRI. The lesion was confirmed to be the lateral head of the gastrocnemius muscle. The specimen obtained from the affected muscle demonstrated degenerative and inflammatory changes together with excess fibrosis. There was no sarcoid lesion or malignancy. From the above results, the present case was thought to have isolated focal myositis. Prednisolone 80 mg (40 mg, twice, at 4-day intervals) was given to the left femoral artery without any trouble. Thereafter the patient became free from pain and difficulty in walking, and the lesion demonstrated by CT scan disappeared in 15 days. However, the high signal intensity on T2 weighted images faintly remained until the 54th day after the treatment. In summary, MRI is more sensitive than CT scan for detection of isolated focal myositis, which might be successfully treated by arterial injection of prednisolone within a short period than any other conventional methods.
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PMID:[A case of isolated focal myositis successfully treated by arterial injection of prednisolone--its findings by CT scan and MRI]. 208 34

Aside from clinical electrophysiology, muscle biopsy is an important method regarding the diagnosis of neuromuscular diseases. Functional disturbances like myasthenia, myotonia, or paramyotonia only lead to slight and unspecific morphological alterations of the muscle tissue. In most cases, progressive muscular dystrophies, myotonic dystrophy, and myositis of various etiologies each have their own bioptic and electrophysiological characteristics. The diagnosis of these diseases should be confirmed by both methods. Some inflammatory diseases, such as panarteriitis nodosa and muscular sarcoidosis, may be diagnosed on account of histologic findings only. The same is true for rhabdomyolysis and congenital myopathies.
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PMID:[Diagnostic value of muscle biopsy in neuromuscular diseases]. 216 Jul 61

The patient is 48 year-old female who has been followed as MCTD with nonsteroidal therapies for 18 years. Sometimes she has been attached by focal severe muscle pain. One year ago, she had general myalgia associated with high fever and arthralgia. The results of the examination, aldolase, GOT, GPT, gamma-GTP, CRP and leucocyte were increased. Muscle biopsy showed noncaseating epithelioid granuloma being in contact with enlarged injected vessels. Out of tough with granuloma, a few fibre necroses, fibrosis of muscle, and degeneration of collagen fiber were recognized. After treatment of nonsteroidal antiinflammatory agents, her every complain was removed. Her muscle looks normal herself. MCTD has myopathy caused by inflammatory infiltrates and fibre necroses. But granulomatous myositis is very rare. It is difficult to differentiate our case from sarcoidosis, especially acute isolated muscle sarcoidosis.
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PMID:[A case of mixed connective tissue disease associated with uncommon acute myopathy caused by isolated muscle epithelioid granuloma]. 221 39

Granulomatous muscle disease is most commonly seen in sarcoidosis, but may be seen in association with a wide variety of other disorders or in isolation. Patients with granulomatous myositis usually present with slowly progressive muscle pain and weakness affecting mainly proximal muscles. There are, however, a few reports of granulomatous muscle disease presenting with flexion contractures of the limbs. Two further patients with granulomatous muscle disease and flexion contractures of the limbs, but with no evidence of systemic granulomatous disease, is presented. It is suggested that such patients represent a separate clinical entity that is distinct from idiopathic granulomatous myositis presenting with muscle pain and weakness. The association of contracturing granulomatous myositis with a long-standing vasculitis in one patient suggests that the two conditions may be related.
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PMID:Contracturing granulomatous myositis: a separate entity. 228 32

We report about two female patients with a histopathological proven granulomatous myositis associated with a fasciitis. One patient showed noncaseating granulomas in the muscle fascia. She suffered from symmetrical contractures of the digital flexors and ankles. The second patient showed uveitis and polyneuropathy, too. In addition, increased activities of the angiotensin-converting-enzyme and lysozyme in the sera suggested that both cases represent a new form of sarcoidosis.
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PMID:[Fasciitis in granulomatous myositis--an atypical manifestation of sarcoidosis?]. 233 6

Causes of the eosinophilia-myalgia syndrome other than L-tryptophan include parasitic myositis (that is, trichinosis), acute tropical myositis, sarcoidosis, granulomatous myositis, polymyositis, collagen vascular diseases, neoplastic myositis, and eosinophilic myositis. Some of these can be excluded by the absence of associated findings, that is, sarcoidosis, collagen vascular disease, neoplastic myositis; or on epidemiologic grounds, for example, acute tropical myositis. A muscle biopsy is diagnostic for trichinosis and for granulomatous, neoplastic, and eosinophilic myositis. A normal erythrocyte sedimentation rate militates against but does not rule out neoplastic or collagen vascular disease-associated myositis. The erythrocyte sedimentation rate may be elevated in most of these disorders although trichinosis is characterized by a very low rate. Most conditions associated with eosinophilia are characterized by both blood and local tissue eosinophilia.
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PMID:The eosinophilia-myalgia syndrome with neuritis associated with L-tryptophan use. 233 56

We report the case of a 69 year old female, who in 1979 presented with a granulomatous myositis confirmed by muscular biopsy. The histology is typical for sarcoidosis, but tests on other organs remained negative for eight years. Up to 1987, 79 cases of sarcoid myopathy have been published in medical journals, of which 44% had an isolated muscular involvement. We discuss the differential diagnosis, the histology, pathology, etiology and the manifestations shown by the EMG of this rare illness, as well as our patient's peculiar signs.
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PMID:[Sarcoidosis: apropos of a case of isolated myopathy]. 274 Jun 74

A series of human multinucleate giant cells (MGCs) of the endocytotic type were studied using enzyme histochemical methods for dehydrogenases, glycosidases, phosphatases, and peptidases. Several enzyme patterns were found. The subgroup of MGCs associated with inflammatory granulomatous processes (sarcoidosis, granulomatous myositis, familial granulomatosis, lymphogranuloma, granulomatous cholangitis) was characterized by high activities of nonspecific esterase (NE) and tartrate-sensitive acid phosphatase (AcPase-Ts). There was no detectable activity of peptidases or tartrate-resistant isoenzyme of acid phosphatase (AcPase-Tr). This enzyme equipment was indistinguishable from that in mononuclear precursors in the granulomas. The other MGCs of the series displayed enzyme patterns substantially different from their monocytic precursors (blood monocytes and Langerhans cells). The subgroup of foreign body associated MGCs (resorption of fat, keratin, and suture material) was characterized by high activities of NE, AcPase-Tr, and greatly variable activities of both peptidases studied. The latter lacked predilection for certain subcellular regions. The subgroup of osteoclasts and so-called giant cell tumours (osteoclastoma, giant cell tumour of soft parts, giant cell epulis of peripheral, and central types) displayed very low activity of NE, high activity of AcPase-Tr, and strong activities of peptidases. The latter were localized near the surface membrane of the polykarya. MGCs in histiocytosis X (HX) differed from the previous group by higher values of NE in average. All MGC types had common denominator in the absence of alkaline phosphatase activity, on average intense dehydrogenase activities, mostly low beta-glucuronidase and highly variable alpha-mannosidase activities. The enzyme pattern heterogeneity is discussed with regard to the phenomenon of enzyme induction and depression occurring in course of polykaryon production. The variability of phenomenon may reflect reactive adaptation to varying functional demands imposed on MGCs under different conditions.
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PMID:Enzyme patterns in human endocytotic multinucleate giant cells--a histochemical study. 287 82

A patient with sarcoidosis who presented with acute inflammatory myopathy is described. The patient had no symptoms other than those of the muscle involvement, with elevated serum levels of creatine kinase. Muscle biopsies revealed epithelioid granulomas, consistent with sarcoidosis. There was a dramatic response to a moderate dose of corticosteroids, but relapse occurred after the dose was tapered. We suggest that sarcoidosis be considered in the differential diagnosis of inflammatory myopathy, and that patients with acute sarcoid myositis be maintained with at least a moderate dose of corticosteroids for at least 6 months.
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PMID:Sarcoidosis presenting as acute myositis. Report and review of the literature. 306 66


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