ABSTRACT
Abstract Anti-tumor necrosis factor drugs are frequently preferred in the treatment of rheumatologic diseases and other inflammatory diseases. The development of myositis after using anti-tumor necrosis factor drugs is a rare clinical condition. Here we aimed to report cases who developed myositis after using anti-tumor necrosis factor drugs and review the current literature. We report two cases of rheumatoid arthritis and a case of ankylosing spondylitis developed idiopathic inflammatory myopathy following anti-tumor necrosis factor therapy. In conclusion, myositis could develop during anti-tumor necrosis factor therapy, so these patients should be evaluated carefully initially for myositis and should be closely monitored due to the potential for developing myositis in treatment process.
Resumo Os fármacos antifator de necrose tumoral (anti-TNF) são frequentemente preferidos no tratamento de doenças reumatológicas e outras doenças inflamatórias. O desenvolvimento de miosite após o uso de anti-FNT é uma condição clínica rara. Este estudo objetivou descrever casos de pacientes que desenvolveram miosite após o uso de anti-TNF e fazer uma revisão da literatura atual. Descrevem-se dois casos de artrite reumatoide (AR) e um caso de espondilite anquilosante (EA) que desenvolveram miopatia inflamatória idiopática após o tratamento com anti-TNF. Em conclusão, pode haver desenvolvimento de miosite durante o tratamento com anti-TNF, de modo que esses pacientes devem ser cuidadosamente avaliados inicialmente à procura de miosite e devem ser cuidadosamente monitorados em razão do potencial de desenvolvimento de miosite no processo de tratamento
Subject(s)
Humans , Male , Female , Adolescent , Young Adult , Tumor Necrosis Factor-alpha/antagonists & inhibitors , Antirheumatic Agents/adverse effects , Adalimumab/adverse effects , Etanercept/adverse effects , Myositis/chemically induced , Arthritis, Rheumatoid/drug therapy , Spondylitis, Ankylosing/drug therapy , Adalimumab/administration & dosage , Etanercept/administration & dosage , Myositis/diagnosisABSTRACT
Abstract Purpose: To analyze the topical effects of Buriti oil (Mauritia flexuosa L.) in induced myositis in rats. Methods: Thirty six male rats divided into three groups: Control group (C), induced myositis group (MI) and induced myositis group reated with Mauritia flexuosa L. (MT). After inducing myositis with 1% acetic acid, was topically applied 0.5 ml of Mauritia flexuosa L.extract on the posterior region of the right gastrocnemius muscle in animals belonging to group MT, for 7 and 14 days. Results: The neutrophil number there was statistically significant difference, after 7 and 14 days, between groups C and MI (p <0.001) (p<0.01). The group MT there was a significant difference in relation to MI group in both experimental times with (p<0.001). The number of fibroblasts in the 14 days showed that when comparing the groups M and MT the differences were also significant (p<0.001). As for the DLL, in 7 days, there was a significant difference between group C and MI group (p <0.001). When considering the MT group, there was a significant difference in relation to the MI group (p <0.001). Conclusion: The extract of Mauritia flexuosa L. leaves lessened acute and chronic inflammation, increased fibroblast proliferation and reduced macroscopically edema.
Subject(s)
Animals , Male , Rats , Plant Oils/administration & dosage , Plant Extracts/administration & dosage , Carotenoids/administration & dosage , Arecaceae/chemistry , Fibroblasts/drug effects , Phytotherapy , Myositis/drug therapy , Carotenoids/pharmacology , Random Allocation , Administration, Topical , Rats, Wistar , Acetic Acid , Disease Models, Animal , Inflammation , Myositis/chemically inducedABSTRACT
ABSTRACT PURPOSE: To analyze the effects of the low-level laser therapy in the acute myositis induced in rats. METHODS: Twelve rats were subjected to bilateral ovariectomy for inducing osteoporosis. After surgery, they were divided into two groups: Ovariectomy-control group (G1, n=6), receiving 0.5 ml distilled water by gavage for 30 days, and Ovariectomy plus mastruz group (G2, n=6), receiving 0.5 ml of the hydroalcoholic extract of mastruz at 10% concentration (50mg) daily, for the same period. Then, the blood of the animals was collected for further biochemical analysis (liver function) and tibia and liver were removed for histological and histomorphometric analyses. RESULTS: In the MT group there was a statistic significant decrease in the number of inflammatory cells, related to the MI group (p<0.05), increase in the fibroblastic proliferation, when compared to groups C and MI related to MT group (p<0.01) and statistic significant edema regression (p=0.0400) in the MT group CONCLUSION: The low-level laser therapy was efficient in the reduction of the inflammatory process, increase of the fibroblastic proliferation and the reduction of the edema.
Subject(s)
Animals , Male , Edema/radiotherapy , Lasers, Semiconductor/therapeutic use , Low-Level Light Therapy/methods , Myositis/radiotherapy , Acute Disease , Fibroblasts/pathology , Models, Animal , Muscle, Skeletal/pathology , Myositis/chemically induced , Radiation Dosage , Random Allocation , Rats, WistarABSTRACT
Drug Rash with Eosinophilia and Systemic Symptoms (DRESS) syndrome reflects a serious hypersensitivity reaction to drugs, characterized by skin rash, fever, lymph node enlargement, and internal organ involvement. So far, numerous drugs such as sulfonamides, phenobarbital, sulfasalazine, carbamazepine, and phenytoin have been reported to cause the DRESS syndrome. We report a case in a 29-yr-old female patient who had been on celecoxib and anti-tuberculosis drugs for one month to treat knee joint pain and pulmonary tuberculosis. Our patient's clinical manifestations included fever, lymphadenopathy, rash, hypereosinophilia, and visceral involvement (hepatitis and pneumonitis). During the corticosteroid administration for DRESS syndrome, swallowing difficulty with profound muscle weakness had developed. Our patient was diagnosed as DRESS syndrome with eosinophilic polymyositis by a histopathologic study. After complete resolution of all symptoms, patch tests were positive for both celecoxib and ethambutol. Although further investigations might be needed to confirm the causality, celecoxib and ethambutol can be added to the list of drugs as having the possibility of DRESS syndrome.
Subject(s)
Adult , Female , Humans , Anti-Inflammatory Agents, Non-Steroidal/adverse effects , Antitubercular Agents/adverse effects , Arthritis/complications , Drug Eruptions/etiology , Eosinophilia/chemically induced , Ethambutol/adverse effects , Myositis/chemically induced , Pyrazoles/adverse effects , Sulfonamides/adverse effects , Syndrome , Tuberculosis, Pulmonary/complicationsABSTRACT
Monoterapia para o tratamento das dislipidemias é frequentemente insuficiente para o alcance das metas recomendadas pelas diretrizes. Entretanto, nos últimos anos, o uso de terapia combinada tem se apresentado como uma nova opção em muitos casos. Uma revisão de 36 estudos envolvendo a combinação de estatinas com fibratos apresentou 29 casos de rabdomiólise e uma prevalência geral de miopatia de 0,12 por cento. A combinação de estatinas com o genfibrozil parece causar mais rabdomiólise que com os fibratos de nova geração (especialmente quando comparado com fenofibrato ou bezafibrato). Idade avançada, diabetes, mulheres, medicações concomitantes, disfunção renal, consumo excessivo de álcool, exercícios, traumatismos e cirurgias estão também associados com maior risco de efeitos adversos.
Subject(s)
Humans , Male , Female , Clofibric Acid/adverse effects , Hydroxymethylglutaryl-CoA Reductase Inhibitors/adverse effects , Age Factors , Clofibric Acid/therapeutic use , Drug Interactions , Drug Therapy, Combination , Dyslipidemias/drug therapy , Gemfibrozil/adverse effects , Gemfibrozil/therapeutic use , Hypertriglyceridemia/drug therapy , Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic use , Myositis/chemically induced , Rhabdomyolysis/chemically induced , Sex FactorsABSTRACT
Inhibitors of cytochrome P 3A4 are known to increase serum concentration of simvastatin and enhance its toxicity. This study is designed to evaluate the effects and compare erythromycin and azithromycin in their interaction with simvastatin. Sixty rats were used distributed equally to 6 groups. Control groups comprised a negative control [1[st] group], erythromycin [2[nd] group], azithromycin [3[rd] group] and simvastatin [4[th] group]. Simvastatin and erythromycin were concomitantly given to the 5th group while simvastatin azithromycin combination served as the 6[th] group. The drugs were orally administered at therapeutic doses of 18 mg/kg b.w. of erythromycin 9 mg/kg b.w. of azithromycin and 3.24 mg/kg b.w. of simvastatin. The drugs were given as single daily dose for 10 days. Assessment of serum creatinine, creatinine phosphokinase [CPK], aspartate aminotransferase [SGOT] and alanine aminotransferase [SGPT] was supplemented by skeletal muscle histopathology of rectus abdominis and quadriceps muscles of the thigh. A significant elevation of CPK was evident in all groups receiving simvastatin either alone or in combination with erythromycin or azithromycin. Compared with all other groups, the group of rats receiving erythromycin and simvastatin combination manifested a more significant elevation of CPK, SGOT, SGPT and serum creatinine. Biochemical results were supplemented with an evident myositis, degeneration and necrosis demonstrated at a higher rate in the simvatatin erythromycin combination group. No significant biochemical or pathologic change was noticed between simvastatin and azithromycin simvastatin combination group. As shown from this study azthromycin greatly enhanced the simvastatin - induced muscles toxicity, an interaction not demonstrated when azithromycin was co-administered with simvastatin. Erythromycin considered as an inhibitor to the cytochrome P 3A4, should be omitted and replaced by azithromycin whenever necessary in patients treated with simvastatin
Subject(s)
Animals, Laboratory , Myositis/chemically induced , Azithromycin , Erythromycin , Drug Interactions , Rats , Creatinine/blood , Creatine Kinase/blood , Transaminases/blood , Muscles/pathologySubject(s)
Drug Therapy/adverse effects , Gout/chemically induced , Humans , Lupus Erythematosus, Systemic/chemically induced , Myositis/chemically induced , Osteomalacia/chemically induced , Osteonecrosis/chemically induced , Osteoporosis/chemically induced , Rheumatic Diseases/chemically induced , Scleroderma, Systemic/chemically inducedABSTRACT
Os autores descrevem o caso de uma enferma que apresentou síndrome polimiosite símile durante tratamento de hipercolesterolemia com clofibrate. Com a suspensäo da medicaçäo, os sinais e sintomas de acometimento muscular desapareceram por completo. Os autores chamam a atençäo para a importância das miopatias iatrogênicas no diagnóstico diferencial de pacientes com doenças do sistema neuromuscular
Subject(s)
Humans , Female , Aged , Clofibrate/adverse effects , Myositis/chemically induced , Clofibrate/therapeutic use , Hypercholesterolemia/drug therapyABSTRACT
Os autores relatam um caso de artrite reumatóide que desenvolveu miastenia gravis (MG) e polimiosite (PM) após uso de D-penicilamina. O diagnóstico de MG e PM associados foi baseado em achados eletroneurográficos, enzimas musculares elevadas e biópsia muscular. Os autores discutem a reduçäo dessas drogas pelo uso de diferentes drogas e a infreqüente associaçäo de duas entidades miopáticas numa mesma paciente
Subject(s)
Adult , Humans , Female , Myasthenia Gravis/chemically induced , Myositis/chemically induced , Penicillamine/adverse effects , Arthritis, Rheumatoid/drug therapy , Biopsy , Penicillamine/therapeutic useABSTRACT
Relata-se um caso fatal de intoxicaçäo sistêmica por podofilina, que apreentou quadro neurológico grave, com tetraplegia e arreflexia global intermitente, elevaçäo de aminotransferases, enzimas musculares e acentuada leucocitose. Duas biópsias consecutivas revelaram miosite externa e a eletromiografia polineuropatia grave
Subject(s)
Adult , Humans , Male , Myositis/chemically induced , Podophyllin/poisoning , Condylomata Acuminata/drug therapy , Podophyllin/therapeutic use , Warts/drug therapyABSTRACT
Se estudió los cambios y la composición del infiltrado inflamatorio que se desarrolla en el músculo gastronemio de ratones a consecuencia de inoculaciones de veneno de serpiente "terciopelo" (Bothrops asper). El veneno produjo una severa y rápida mionecrosis, de acuerdo al análisis histológico y a la drástica disminución de los niveles musculares de la enzima creatina quinasa (CK). Se observó un escaso infiltrado inflamatorio a las 6 hr, pero hubo un aumento evidente a las 24, 48, y 72 hr. A las 6 y 24 hr el infiltrado presentó un predominio de leucocitos polimorfonucleares neutrófilos, en tanto que a las 48 y 72 hr se observó un aumento en el porcentaje de macrófagos. Histológicamente, las células inflamatorias se observaron en el interior de las fibras musculares necróticas, así como en el espacio intersticial; sin embargo, algunas áreas necróticas no contenían células inflamatorias. En un intento por correlacionar la presencia de células inflamatorias con la degradación de las proteínas miofibrilares, se observó muy poca degradación proteica a las 6 hr. Por otra parte, a las 48 hr se dio una disminución de las proteínas "no colágenas" del músculo, así como una disminución en algunos componentes miofibrilares, de acuerdo al análisis electroforético. Las enzimas proteolíticas presentes en células inflamatorias pueden jugar un papel importante en la degradación de las proteínas miofibrilares luego de mionecrosis inducida por el veneno de B. asper