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

A case of eosinophilic polymyositis is reported. Tender muscle swelling was followed by proximal weakness, creatinine kinase elevation, and electromyographic features typical of polymyositis. Severe myocarditis, pericarditis and heart failure were present. Muscle biopsy specimen showed active myositis with eosinophil infiltrate. Unlike previous cases, blood eosinophils count was normal. The clinical response to corticosteroids was excellent, and a relapse occurring as steroid dose was lowered responded rapidly to an increased dose of prednisolone. Eosinophilic polymyositis may be a component of a general systemic illness with prominent cardiac involvement.
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PMID:Eosinophilc polymyositis. 50 94

Twenty-nine patients with myositis, including 10 with polymyositis (PM), 6 with dermatomyositis (DM), and 13 with myositis associated with a connective tissue disease (CTD), were followed up for a mean observation time of 49 months. The 13 patients with CTD-associated myositis were further separated by the presence or absence of anti-RNP antibodies. The functional disability at diagnosis was pronounced without differences between the groups. The patients with anti-RNP antibodies did not differ from the other patients regarding initial muscle weakness, erythrocyte sedimentation rate, or creatinine phosphokinase values, but the histopathological muscle changes were generally milder. Rapid improvement of muscle strength on moderate doses of corticosteroids was seen in most patients. At the end of study, corticosteroid treatment had been withdrawn from 17 patients because of remission, including 6 of the 7 patients with anti-RNP antibodies. The presence of electromyographic changes compatible with myositis, pronounced muscle weakness before treatment, and a low erythrocyte sedimentation rate seemed to indicate a less favorable outcome unrelated to diagnostic subgroupings. However, the combination was rarely found among the anti-RNP-positive patients.
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PMID:A clinical, serological, and histopathological study of myositis patients with and without anti-RNP antibodies. 143 44

A case study is given of a 25-year old woman with rhabdomyolysis associated with HIV infection. The presenting symptoms were a 1-week history of backache, gross swelling of both hands and feet, and weakness and marked pain in most muscle groups; 3 days before admission the urine was black and she was unable to walk. Multiple, firm 1-2 cm lymph nodes were revealed during examination. White blood cell count (WBC) was 22,000/microliter with 12 pc lymphocytes, 7.3 pc monocytes, and 80.5 pc polymorphonuclear leukocytes. Hemoglobin concentration was 15.8 g/deciliter; platelet count was 124,000/microliter with a Westergren ESR of 109 mm/h. An antinuclear antibody test was negative. Serum concentration of urea was 3.8 mmol/liter, creatinine 42 microliter/liter, sodium 128 mmol/liter, and potassium 5.9 mmol/liter. Microscopic examination of urine revealed WBC 100/HPF, red blood cells 20/HBF, and granular casts. The dipstick test showed blood land protein in the urine. Electromyography showed inflammatory myopathy. Creatine Kinase (CK) concentration was 2359 IU/liter and lactate dehydrogenase concentration 1000 IU/liter. Hemolysis was present from clinical or laboratory signs. The patient tested HIV positive by ELISA (Abbott) and Western blot (Dupont). Treatment consisted of administration of 60 mg/day of prednisolone orally. Over 2 weeks, swelling of limbs was reduced and CK concentration was reduced to 931 IU/liter. The patient was discharged and did not keep a follow-up appointment. The patient did not have a history of other predisposing conditions, only HIV infection and persistent muscle weakness and inflammatory myopathy. There is evidence from other patient studies of myopathy associated with HIV infection and polymyositislike illness. In this case study, the patient may have had a acute form of polymyositis, or acute viral myositis such as occurs with echo, influenza, coxsackie, and other viral infections. A detailed viral investigation was not performed. HIV infection may have directly infected myocytes or immunosuppression predisposing to acute myositis by other pathogens. HIV-related muscle disease should include rhabdomyolysis.
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PMID:Rhabdomyolysis associated with human immunodeficiency virus (HIV) infection. 180 50

The efficacy and tolerance of 750 mg of Acipimox was tested in 38 pts with primary dyslipidemias: 20 type IIa, 12 type IIb, and 6 type IV. All pts had been poor responders to a 2 month diet according to the recommendations of the National Cholesterol Education Program. Clinical examination, eye fundus, and the following laboratory tests: total cholesterol (TC), HDL, triglycerides (TG), total bilirubin, alkaline phosphatase, oxalacetic and pyruvic transaminases, uric acid, plasmatic creatinine, albumin, postprandial glucose test, hematocrit, white blood and platelet count were performed 60 days before drug initiation, 60 and 180 days after treatment had been started. No side effects were observed (myositis, visual gastrointestinal). 50% of the pts had slight to moderate flushing which appeared the first 3 days and lasted 14 +/- 7 days after treatment had been started. Plasmatic creatinine increased from 0.89 to 1.86 mg/dl in pt with one kidney, returning to normal levels 30 days after Acipimox interruption. After 180 days of therapy in the IIa group TC was -27% (p < 0.001), HDL + 15% (p < 0.001); in the IIb group: TC-23% (p < 0.001), HDL +9% (NS), TG -48% (p < 0.001); and in the IV group: TC-10% (p < 0.05), HDL +20% (p < 0.001), TG-53% (p < 0.001). Acipimox is well tolerated and is useful as a lipid-lowering drug in type IIa, IIb and IV dyslipidemias. Further studies are necessary to clear effects of the drug on renal metabolism and on long term survival of coronary pts.
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PMID:[Acipimox in primary hyperlipidemias: safety and efficacy evaluated in six months]. 184 8

The second generation fibric acid derivative, bezafibrate (Bezalip, Norlip) is widely used as a hypolipemic agent throughout Europe and Israel. Its side-effects are well documented, and include myositis, which is considered very rare. We report a 55-year-old diabetic woman with hypertension who had mild renal dysfunction (creatinine 2.0 mg/dl) who received 400 mg/d bezafibrate because of combined (Type IIb) hyperlipoproteinemia. She developed acute myositis, with extreme muscle weakness, pain and CPK levels of up to 3500 units. On discontinuation of the drug all clinical and biochemical features ceased and complete cure followed. No other symptoms have appeared during 2 years of followup. The few reports of such cases in the German literature point to a greater prevalence of myositis in those with renal dysfunction. Early diagnosis of bezafibrate-induced myositis is crucial, a discontinuation of the drug results in cure.
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PMID:[Acute severe myositis due to bezafibrate treatment]. 272 79

In 1985 and 1986, large-scale natural die-offs of sandhill cranes in Texas were attributed to fusariomycotoxicosis. These birds demonstrated a progressive loss of motor control to the neck, wings, and legs. Based on necropsy and/or histopathology of 31 cranes, the most common lesions involved skeletal muscle and included hemorrhages, granulomatous myositis, thrombosis, and vascular degeneration. Serum chemistry results revealed that levels of creatinine kinase, aspartate aminotransferase, and alanine aminotransferase were above published normals. However, only alanine aminotransferase was higher in clinically affected cranes than in normal cranes collected from the same area.
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PMID:Suspected fusariomycotoxicosis in sandhill cranes (Grus canadensis): clinical and pathological findings. 277 94

We report the case of a 6-year-old boy who presented with difficulty ambulating and an elevated creatinine phosphokinase level following an upper respiratory tract infection. Crural myositis was diagnosed; convalescent serum was negative for viruses, but demonstrated significant titers to Mycoplasma pneumoniae. Benign acute crural myositis has not heretofore been associated with Mycoplasmal infection.
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PMID:Myalgia cruris epidemica (benign acute childhood myositis) associated with a Mycoplasma pneumonia infection. 356 74

Six horses had been admitted to the hospital because of illness other than renal failure; diarrhoea, myositis, abdominal pain and/or suspected bacterial sepsis. Hypotension and disseminated intravascular coagulopathy were frequent findings in the horses. Abnormally high serum creatinine concentration and urine specific gravity of less than 1.022 were found in the horses with acute renal failure. Hyponatraemia and hypochloraemia were the most common abnormal electrolyte findings. Pronounced hyperkalaemia was not found. Variable degrees of tubular necrosis were seen in three of the four horses that had kidney sections submitted for microscopic examination. Renal cortical necrosis occurred in one horse. Intravenous fluid and electrolyte replacement was the most important therapy in those cases that were non-oliguric. Furosemide, mannitol and dopamine were used in horses with oliguria. The prognosis was generally good if the predisposing cause could be corrected and the acute renal failure was not oliguric.
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PMID:Acute renal failure in six horses resulting from haemodynamic causes. 360 51

Thirty-one patients with rheumatoid arthritis were consecutively studied for evidence of muscle involvement, using muscle biopsy and electromyography. The patients were initially separated into 4 clinical categories: inactive peripheral joint disease (6 patients); active peripheral joint disease (10 patients); systemic disease and a disproportionately elevated sedimentation rate for the degree of mild synovitis (SERD) (11 patients); or elevated creatinine phosphokinase level (4 patients). In addition to routine histology, muscle tissue was examined for de novo synthesis of IgM and IgM rheumatoid factor, and by indirect immunofluorescence for the presence of immunoglobulin and complement deposits. Our results indicate that: muscle fiber necrosis occurs frequently in patients with rheumatoid arthritis; rheumatoid myositis, defined as muscle fiber necrosis and mononuclear cell infiltration, is a distinct entity and occurs particularly in patients with SERD or an elevated creatinine phosphokinase level; and only muscle from patients with rheumatoid myositis exhibited de novo synthesis of rheumatoid factor and significant quantities of IgM, indicating that local immune events may be important in the pathogenesis of this entity.
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PMID:Rheumatoid myositis. Clinical and histologic features and possible pathogenesis. 637 9

Hypertriglyceridaemia, an atherogenic risk factor, is a well recognised complication of uraemia, and is present in the earliest stages of the disease. Bezafibrate is an effective hypolipidaemic agent, and its effect in moderate to severe uraemia is documented in this study. Significant reductions in serum triglyceride and cholesterol have been achieved after 1 month's therapy with a reduced dosage of bezafibrate. A reduction in the hyperinsulinaemia was also seen, but no change in the fractional removal rate of injected lipid emulsion (K2) was observed. An accelerated decline in some patients' renal function was observed, which was partially reversed on cessation of treatment. Reversible elevations in the serum creatinine phosphokinase were also seen, but no patient exhibited the myositis-like syndrome associated with clofibrate.
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PMID:The short term effects of bezafibrate on the hypertriglyceridaemia of moderate to severe uraemia. 638 24


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