A case of eosinophilic myositis in continuum from localized nodular myositis

DOI Web Site 1 Citations 40 References
  • Matsuse Dai
    Department of Neurology, Neurological Institute, Graduate School of Medical Sciences, Kyushu University
  • Ikezoe Koji
    Department of Neurology, Neurological Institute, Graduate School of Medical Sciences, Kyushu University
  • Shigeto Hiroshi
    Department of Neurology, Neurological Institute, Graduate School of Medical Sciences, Kyushu University
  • Murai Hiroyuki
    Department of Neurology, Neurological Institute, Graduate School of Medical Sciences, Kyushu University
  • Ohyagi Yasumasa
    Department of Neurology, Neurological Institute, Graduate School of Medical Sciences, Kyushu University
  • Kira Jun-ichi
    Department of Neurology, Neurological Institute, Graduate School of Medical Sciences, Kyushu University

Bibliographic Information

Other Title
  • 限局性結節性筋炎から好酸球性筋炎へ移行した１例
  • 症例報告 限局性結節性筋炎から好酸球性筋炎へ移行した1例
  • ショウレイ ホウコク ゲンキョクセイ ケッセツセイ キンエン カラ コウサンキュウセイ キンエン エ イコウシタ 1レイ

Search this article

Abstract

We report a 72-year-old man with eosinophilic myositis (EM). At age 71 he noticed a painful nodule in his left calf. A biopsy (first biopsy) showed marked infiltration of mononucleated cells and necrotic muscle fibers. Several phagocytosed fibers were also seen. He was diagnosed as having myositis. The painful nodule disappeared spontaneously. At age 72, he again had a painful nodule, but this time in his right calf; again, this disappeared spontaneously on the first admission. Just after discharge, he noted painful nodules in the left thigh and right anterior tibial muscles and was again admitted (second admission). Neurological examination revealed mild proximal-dominant weakness in all four extremities but no other abnormalities. Laboratory studies showed elevated creatine kinase (CK) level (38,803U/l; normal 62-287) and positive Jo-1 antibody, but no eosinophilia. Needle electromyography of the limb muscles showed myogenic patterns. Magnetic resonance imaging of the lower limbs demonstrated several T2-high and gadolinium (Gd)-enhanced lesions. Muscle biopsy (second biopsy) from the left quadriceps femoris showed marked infiltration of eosinophils; he was diagnosed as having EM. Administration of prednisolone was initiated at 60 mg/day and then gradually tapered. After starting treatment with steroids, his muscle weakness gradually ameliorated, CK level dramatically decreased, and the nodules disappeared. Clinically, the patient had developed localized nodular myositis (LNM), but pathologically it was EM without peripheral blood eosinophilia and positive Jo-1 antibody that is occasionally found in polymyositis (PM). Thus, this patient demonstrated overlapping characteristics of EM, LNM, and possibly PM, suggesting that a common mechanism underlay these conditions. As discussed, the involvement of eosinophils in three inflammatory myopathies was indicated.<br>

Journal

Citations (1)*help

See more

References(40)*help

See more

Keywords

Details 詳細情報について

Report a problem

Back to top