Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 20 de 550
Filter
1.
Arch. argent. pediatr ; 120(2): e93-e97, abril 2022. ilus
Article in Spanish | LILACS, BINACIS | ID: biblio-1363988

ABSTRACT

La miositis de origen vírico o bacteriano es frecuente en la edad pediátrica. Causa dolor muscular y debilidad, con fiebre y malestar general. Una causa es la infección por Bartonella henselae, bacteria implicada en la enfermedad por arañazo de gato que, a veces, causa afectación multisistémica. Se presenta el caso de una adolescente que acudió al servicio de urgencias por mialgia intensa, malestar, adelgazamiento y esplenomegalia. En el labortorio se observaron parámetros inflamatorios elevados. Refería contacto con un gato. Entre los estudios realizados, la resonancia magnética (RM) de miembros inferiores mostró una imagen compatible con miositis inflamatoria bilateral. En la RM abdominal, se observaron tres lesiones esplénicas no detectadas previamente y el fondo de ojo mostraba una lesión compatible con oclusión arterial retiniana o vasculitis. Se indicó tratamiento antibiótico por vía intravenosa durante 21 días con cefotaxima y cloxacilina, tras los cuales desaparecieron los signos y síntomas, aunque los reactantes inflamatorios persistieron elevados. Con base en el cuadro clínico (miositis + coriorretinitis + absceso esplénico) se pensó en una posible infección por B. henselae y se inició tratamiento oral con azitromicina y rifampicina durante 14 días. Luego del tratamiento, los valores de laboratorio fueron normales, así como la RM de control, y se constató una IgG positiva para la bacteria


Infectious myositis, whether viral or bacterial, is frequent in pediatric age. It causes muscle pain and weakness, associated with fever and general malaise. One cause is Bartonella henselae, responsible for cat scratch disease, which sometimes causes systemic symptoms. We report the case of an adolescent who came to the emergency room with intense myalgia, malaise, weight loss and splenomegaly. Blood tests showed high inflammatory markers. She had been in touch with a cat. Studies were carried out including: lower limbs MRI suggestive of bilateral inflammatory myositis, abdominal MRI with three previously undetected splenic lesions and dilated fundus examination that showed possible retinal arterial occlusion or vasculitis. After 21 days of intravenous antibiotic therapy (cefotaxime + cloxaciline), she became asymptomatic, but inflammatory markers remained high. Suspecting Bartonella henselaeinfection (myositis + chorioretinitis + splenic abscess), oral azithromycin and rifampicin were prescribed for 14 days. Blood tests and control MRI became normal, and IgG was positive.


Subject(s)
Humans , Female , Adolescent , Splenic Diseases/complications , Splenic Diseases/microbiology , Vasculitis , Cat-Scratch Disease/complications , Cat-Scratch Disease/diagnosis , Cat-Scratch Disease/drug therapy , Bartonella henselae , Myositis/diagnosis , Myositis/etiology
2.
Medicina (B.Aires) ; 81(3): 462-466, jun. 2021. graf
Article in English | LILACS | ID: biblio-1346486

ABSTRACT

Abstract PTH-independent hypercalcemia due to granulomatous disease is well-documented and sarcoidosis is the most characteristic disease, although there are others. We describe a case of sarcoid-like granulomatous myositis. An 87-year-old man was referred with tetraparesis and hypercalcemia (albumin-corrected calcium of 13.4 mg/dl) following a trip to the Caribbean. The evaluation showed a suppressed PTH, 25-hydroxy vitamin D of 7.5 ng/ml, 18F-FDG PET/CT showed markedly increased uptake in intercostal, back, shoulder, but tock and thigh muscles and a deltoid biopsy confirmed extensive granulomatous myositis. He was prescribed glucocorticoids which resulted in normalized plasma calcium levels and complete recovery from tetraparesis. Sarcoid-like granulomatous myositis should be incorporated into the differential diagnosis of PTH-independent hypercalcemia, especially in the absence of clinical features of sarcoidosis and with special emphasis on the use of 18F-FDG PET/CT to ensure a correct approach.


Resumen La hipercalcemia PTH-independiente asociada a enfermedades granulomatosas está bien documentada y la sarcoidosis es la enfermedad más característica, a pesar de que existen otras. Des cribimos un caso de miositis granulomatosa simil-sarcoidea. Un hombre de 87 años consultó por tetraparesia e hipercalcemia (calcio corregido por albúmina 13.4 mg/dl) luego de un viaje al Caribe. La evaluación mostró una PTH suprimida, 25-hidroxivitamina D 7.5 ng/ml, 18F-FDG PET/CT mostró marcado aumento de captación a nivel de musculatura intercostal, dorsal, deltoidea, glúteos y muslos. Una biopsia deltoidea confirmó una miositis granulomatosa extensa. Se prescribieron glucocorticoides, resultando en normalización del calcio plasmático y completa recuperación de la tetraparesia. La miositis granulomatosa simil-sarcoidea debe ser incorporada den tro del diagnóstico diferencial de la hipercalcemia PTH-independiente, especialmente en ausencia de hallazgos clínicos de sarcoidosis y con especial énfasis en el uso de 18F-FDG PET/CT para su correcta aproximación.


Subject(s)
Humans , Male , Aged, 80 and over , Sarcoidosis/complications , Sarcoidosis/diagnosis , Hypercalcemia/diagnosis , Hypercalcemia/etiology , Myositis/complications , Myositis/diagnosis , Positron Emission Tomography Computed Tomography , Granuloma/complications , Granuloma/diagnosis
3.
Rev. cuba. med ; 60(2): e1345, tab
Article in Spanish | LILACS, CUMED | ID: biblio-1280351

ABSTRACT

RESUMEN Introducción: Las miopatías inflamatorias idiopáticas constituyen un grupo de enfermedades musculares caracterizadas por debilidad muscular crónica e inflamación muscular de etiología desconocida. Objetivo: Identificar las características clínicas e inmunológicas y daño de órganos en pacientes con miopatías inflamatorias idiopáticas. Método: Se realizó estudio observacional, descriptivo, transversal en 52 pacientes con diagnóstico de miopatía inflamatoria idiopática, seguidos en la consulta protocolizada de Reumatología del Hospital Clínico Quirúrgico "Hermanos Ameijeiras" entre enero 2016 y enero 2017. Para las variables cualitativas se calcularon los porcentajes de cada grupo. Se utilizó Chi-cuadrado de Pearson (Estadístico exacto de Fisher), nivel de significación del 95 % (α=0,05) para relacionar la presencia de anticuerpos y el tipo de miopatía, así como la presencia de manifestaciones clínicas de miopatías inflamatorias idiopáticas. Resultados: Del total de pacientes estudiadas, 80,8 % fueron mujeres, 61,5 % de color de piel negra, 86,5 % de procedencia urbana. La edad media al comienzo fue 42,8 ± 13,2 años, tiempo de demora al diagnóstico de 8,8 ± 7,0 meses, tiempo medio de evolución de la enfermedad de 7,5 ± 7,1 años, 80,8 % estaban en remisión, 50 % tenía anticuerpos específicos. La hipertensión arterial se encontró en 28,8 % de los pacientes y 23,1 % presentó neumonía intersticial. La artritis estuvo presente en 96,2 %, 26,9 % presentaron anticuerpos específicos Jo1 y 21,2 % Ro 52. Conclusiones: Predominaron los pacientes del sexo femenino, en la cuarta década de la vida, de procedencia urbana. Los anticuerpos específicos encontrado con más frecuencia fue el anti Jo-1, que se asoció a la presencia de neumopatía intersticial.


ABSTRACT Introduction: Idiopathic inflammatory myopathies constitute a group of muscle diseases characterized by chronic muscle weakness and muscle inflammation of unknown etiology. Objective: To identify the clinical and immunological characteristics and organ damage in patients with idiopathic inflammatory myopathies. Method: An observational, descriptive, cross-sectional study was carried out in 52 patients with diagnosis of idiopathic inflammatory myopathy, followed up in the protocolized service of Rheumatology at Hermanos Ameijeiras Clinical Surgical Hospital from January 2016 to January 2017. The qualitative variables were calculated with the percentages in each group. Pearson's Chi-square (Fisher's exact statistic) (95% significance level (α = 0.05) was used to relate the presence of antibodies and the type of myopathy as well as the presence of clinical manifestations of idiopathic inflammatory myopathies. Results: 80.8% were women of the total patients studied, 61.5% non-white skin color, 86.5% of urban origin. The mean age at the beginning was 42.8 ± 13.2 years, time delay to diagnosis was 8.8 ± 7.0 months, mean time of evolution of the disease of 7.5 ± 7.1 years. 80.8% were in remission, 50% had specific antibodies. Hypertension was found in 28.8% of the patients and 23.1% had interstitial pneumonia. Arthritis was present in 96.2%. We found 26.9% had specific Jo1 antibodies and 21.2% Ro 52. Conclusions: Urban origin female patients predominated, in their fourth decade of life, the more frequent specific antibodies found was anti Jo-1, which was associated with the presence of interstitial lung disease.


Subject(s)
Humans , Female , Dermatomyositis/diagnosis , Myositis/epidemiology , Epidemiology, Descriptive , Cross-Sectional Studies , Observational Study
4.
Article in English | WPRIM | ID: wpr-922392

ABSTRACT

Juvenile dermatomyositis (JDM) is an autoimmune disease manifesting as proximal muscle weakness and skin rash and can involve multiple systems and visceral organs. Myositis-specific autoantibodies (MSAs) are highly associated with various complications and prognosis in JDM. Patients with anti-Mi-2 antibodies tend to have good prognosis and typical clinical symptoms. Patients with anti-MDA5 antibodies often have diffuse interstitial lung disease and skin ulcer, with mild symptoms of myositis. Patients with anti-NXP2 antibodies often have calcinosis, and such antibodies are associated with gastrointestinal bleeding and perforation. Patients with anti-TIF1-γ antibodies have diffuse and refractory skin lesions. Anti-SAE antibodies are rarely detected in children, with few reports of such cases. This article reviews the features of clinical phenotypes in JDM children with these five types of MSAs, so as to provide a basis for the clinical treatment and follow-up management of children with JDM.


Subject(s)
Autoantibodies , Dermatomyositis , Humans , Lung Diseases, Interstitial/etiology , Myositis , Prognosis
5.
Rev. bras. parasitol. vet ; 30(4): e012021, 2021. tab, graf
Article in English | LILACS, VETINDEX | ID: biblio-1347266

ABSTRACT

Abstract Trichinellosis is a zoonosis results from eating raw or semi-cooked meat of infected animals. Medicinal plants have been used lately as alternatives and/or combined therapies to resolve some drawbacks of the current regimens. This work analyzed the effect of albendazole monotherapy on Trichinella spiralis experimental infection (group A), in comparison to P. granatum and amygdalin extracts +cobalamin (group B), plus its combination with albendazole (group C). The study revealed that the extracts alone or combined with albendazole had an inferior effect to albendazole monotherapy regarding number of adult worms (40.83 ±3.82, 18.67 ±1.86 and 16.83 ±2.32, respectively). However, their effect was more obvious in muscle phase combined with albendazole, achieving the lower number of larvae/mL tissue homogenate (22.33 ±3.27 in comparison to 39.67 ±2.58 achieved by albendazole monotherapy). The extracts exerted a significant immunomodulatory effect by reducing the local CD4+ expression in the intestine as well as in muscle phase (1.15 ±0.25 and 3.80 ±0.65 in comparison to 4.97 ±0.37 and 12.20 ±0.87 with albendazole monotherapy, respectively). So, these extracts improved the therapeutic efficacy of albendazole, specifically in muscle phase and counteracted the inflammatory reaction caused by albendazole monotherapy, thus extensively alleviating the resulting myositis.


Resumo Trichinellosis é uma zoonose resultante da ingestão de carne crua ou semicozida de animais infectados. As plantas medicinais têm sido usadas, ultimamente, como alternativas e/ou terapias combinadas, para resolver algumas desvantagens dos regimes atuais. Este trabalho analisou o efeito da monoterapia albendazole na infecção experimental por Trichinella spiralis (grupo A), em comparação com extratos de P. granatum e amígdalina +cobalamina (grupo B), além de sua combinação com albendazol (grupo C). O estudo revelou que os extratos sozinho ou combinado com albendazol teve efeito inferior à monoterapia albendazol em relação ao número de vermes adultos (40,83 ±3,82, 18,67 ±1,86 e 16,83 ±2,32, respectivamente). No entanto, seu efeito foi mais óbvio na fase muscular combinado com o albendazol, alcançando o menor número de larvas/mL homogeneizado de tecido (22,33 ±3,27 em comparação com 39,67 ±2,58 obtidos pela monoterapia albendazol). Os extratos exerceram um efeito imunomodulatório significativo, ao reduzir a expressão local CD4+ no intestino, bem como na fase muscular (1,15 ±0,25 e 3,80 ±0,65 em comparação com 4,97 ±0,37 e 12,20 ±0,87 com monoterapia albendazol, respectivamente). Assim, esses extratos melhoraram a eficácia terapêutica do albendazol, especificamente na fase muscular e neutralizaram a reação inflamatória causada pela monoterapia albendazol, aliviando extensivamente a miosite resultante.


Subject(s)
Animals , Trichinellosis/drug therapy , Trichinellosis/veterinary , Trichinella spiralis , Pomegranate , Amygdalin , Myositis/veterinary , Vitamin B 12 , Plant Extracts , Albendazole , Disease Models, Animal , Larva
6.
Rev. cuba. reumatol ; 22(3): e844, graf
Article in Spanish | LILACS, CUMED | ID: biblio-1144532

ABSTRACT

Aunque los métodos de imágenes aún no se han introducido en los criterios de clasificación de la miositis, el uso de imágenes musculares en la evaluación de las miopatías inflamatorias idiopáticas (MII) ha crecido a lo largo de los años. Las diferentes técnicas de imagen han demostrado ser útiles, pero la RM sigue siendo el estándar de oro para la imagen muscular. Sin embargo, el alto costo y las contraindicaciones en algunos pacientes, hacen considerar otros métodos como el ultrasonido muscular. Esta revisión tiene el objetivo de ofrecer una visión general de las diferentes técnicas de ultrasonido que se han estudiado y proporcionar información a los reumatólogos sobre el papel actual del ultrasonido para diagnosticar las MII. Existen diversos factores que pueden influir en la medición de los parámetros musculares: estandarizar la configuración de la máquina, el plano de visión y la posición del paciente, ya que pueden afectar la medición de la intensidad del eco y el grosor muscular. En el caso de las miopatías inflamatorias influyen otros factores en los resultados de la imagen: sexo, edad, escala de grises de la imagen, cambios en la calidad muscular, intensidad del eco, grosor, tamaño y ecogenicidad muscular. La ecografía muscular es una herramienta próxima en la evaluación de los trastornos neuromusculares y las miopatías inflamatorias. Es fácilmente aplicable en diversos entornos clínicos, no tiene contraindicaciones y proporciona una alternativa rentable a otras modalidades de imágenes como la resonancia magnética(AU)


Although imaging methods have not yet been introduced into the myositis classification criteria, the use of muscle imaging in the evaluation of IIMs has grown over the years. Different imaging techniques have proven helpful, but MRI remains the gold standard for muscle imaging. In this review, the objective is to provide an overview of the different ultrasound techniques that have been studied and to provide information to rheumatologists about the current role of ultrasound in the field of IIM. Development: There are multiple factors that can influence the measurement of muscle parameters that must be considered. First, it is important to standardize the machine configuration, the plane of vision and the position of the patient, as these can affect the measurement of echo intensity and muscle thickness. Conventionally, a linear ultrasound probe is used with sufficient frequency (at least 6-12 MHz) to obtain images of the peripheral skeletal muscle. Magnetic resonance imaging remains the gold standard for muscle imaging. However, the role as a diagnostic tool in the field of IIMs has grown over the years, and the promising results of new advanced imaging techniques suggest that it has not yet reached its full potential(AU)


Subject(s)
Magnetic Resonance Spectroscopy , Muscular Diseases/diagnostic imaging , Myositis/diagnostic imaging , Magnetic Resonance Imaging/methods
7.
Rev. cuba. pediatr ; 92(3): e1061, jul.-set. 2020. tab
Article in Spanish | LILACS, CUMED | ID: biblio-1126766

ABSTRACT

Introducción: La miositis aguda benigna infantil es una complicación transitoria de la gripe causada por los virus influenza A o B, observada en pacientes escolares. Objetivos: Contribuir a divulgar las características de la miositis aguda benigna infantil en el personal médico. Métodos: Investigación descriptiva transversal en 18 pacientes con edad inferior a 19 años atendidos con el diagnóstico de esta afección, en el Hospital Pediátrico Docente Cerro desde el primero de octubre hasta 31 de diciembre del 2019. Se tomó muestra de sangre para estudios hematológicos y enzimáticos, determinación de anticuerpos antidengue y exudado nasofaríngeo en busca de virus respiratorios. Se empleó el programa SSPS versión 19. Los resultados se expresaron en valores absolutos, porcentajes, y los del laboratorio clínico, en promedios y desviación estándar. Resultados: Predominó la edad de 5-14 años (88 por ciento), sexo masculino (72,2 por ciento) y residencia en los municipios Cerro y 10 de 0ctubre (55,5 y 22,2 por ciento), respectivamente. El tipo de marcha anormal más frecuente fue la Frankenstein, con un conteo leucocitario promedio de 7,01 × 109 ± 2,16; linfocitosis 53,3 por ciento y promedio de creatininfosfoquinasa 591 µl × L ± 435,74. Todos los pacientes se recuperaron. El virus influenza B se identificó en 77,7 por ciento de las muestras. Conclusiones: La miositis constituyó una complicación por los virus de la gripe en mayor proporción el tipo B, en pacientes varones escolares, que mostraron trastornos en la marcha, examen neurológico normal y creatininfosfoquinasa elevada. Todos los enfermos se recuperaron en los primeros tres días de iniciada la afección(AU)


Introduction: Children mild acute myositis is a transitory complication of the flu caused by the influenza A or B viruses which presents in school patients. Objectives: To contribute to spread the characteristics of children mild acute miositis in the medical staff. Methods: Descriptive cross-sectional research in 18 patients with ages under the 19 years that were attented with a diagnosis of the disease in "Cerro" Pediatric Teaching Hospital from October 1st to December 31st, 2019. There were taken blood samples to do enzymatic and hematologic studies, antidengue antibodies determination and nasopharinx exudates looking for respiratory viruses. SSPS version 19 program was used. The results were expressed in absolute values, percentages, averages and standard deviation. Results: There was predomiance of the ages from 5 to 14 years (88 percent), male sex (72.2 percent) and living in Cerro and 10 de octubre municipalities (55,5 percent and 22,2 percent, respectively). The most frquent type of abnormal walk was the Frankenstein with an average leukocytes count of 7.01 × 109 ± 2.16; lymphocytea of 53.3 percent; and an average of creatinine fosfoquinase 591 µl × L ± 435.74. All the patients recovered. The influenza B virus was identified in 77.7 percent of the samples. Conclusions: Myositis represented a complication by influenza viruses, mainly the type B, in school male patients who showed disorders in the walk, normal neurologic examination and high creatinine phosphokinase. All the patients recovered in the first 3 days after the onset of the disease(AU)


Subject(s)
Humans , Male , Female , Child , Adolescent , Influenza B virus/growth & development , Gait/physiology , Myositis/complications , Epidemiology, Descriptive , Cross-Sectional Studies
8.
Article in Chinese | WPRIM | ID: wpr-828514

ABSTRACT

OBJECTIVE@#To investigate the classification of idiopathic inflammatory myopathies (IIM) based on clinical manifestations and myositis- specific antibodies using cluster analysis.@*METHODS@#We retrospectively analyzed the data of patients with IIM admitted in Nanfang Hospital in 2015-2019. The clinical data of the patients including serum creatine kinase (CK), interstitial lung disease (ILD), cancer, and myositis-specific antibodies were collected for two-step cluster analysis to identify the distinct clusters of patients, whose clinical characteristics were subsequently analysed.@*RESULTS@#A total of 71 patients with IIM were included in this study, including 30 (42.3%) with polymyositis (PM), 20 (28.2%) with classic dermatomyositis (DM), 16 (22.5%) with amyopathic dermatomyositis (CADM), and 5 (7.0%) with immune-mediated necrotizing myopathy (IMNM). Two-step cluster analysis identified 3 distinctive subgroups: Cluster 1 of 15 (51.7%) patients characterized by rash, positive anti-MDA5 antibody and hypoproteinemia ( < 0.05) with normal or slightly elevated CK level, mainly corresponding to CADM; Cluster 2 of 4 (57.1%) patients with significantly elevated CK and positive anti-SRP antibody ( < 0.001) corresponding to IMNM; and Cluster 3 of 17 (48.6%) patients consisting primarily of patients with PM, characterized by positivity for anti- aminoacyl transfer RNA synthetases antibodies (=0.022) corresponding to antisynthetase syndrome (ASS).@*CONCLUSIONS@#Patients with IIM can be divided into 3 subgroups based on their clinical and serological characteristics (especially myositis-specific antibodies), and among them ASS may represent an independent IIM subgroup with unique clinical characteristics.


Subject(s)
Antibodies , Metabolism , Humans , Myositis , Classification , Retrospective Studies
9.
Article in Chinese | WPRIM | ID: wpr-828933

ABSTRACT

OBJECTIVE@#To investigate the classification of idiopathic inflammatory myopathies (IIM) based on clinical manifestations and myositis- specific antibodies using cluster analysis.@*METHODS@#We retrospectively analyzed the data of patients with IIM admitted in Nanfang Hospital in 2015-2019. The clinical data of the patients including serum creatine kinase (CK), interstitial lung disease (ILD), cancer, and myositis-specific antibodies were collected for two-step cluster analysis to identify the distinct clusters of patients, whose clinical characteristics were subsequently analysed.@*RESULTS@#A total of 71 patients with IIM were included in this study, including 30 (42.3%) with polymyositis (PM), 20 (28.2%) with classic dermatomyositis (DM), 16 (22.5%) with amyopathic dermatomyositis (CADM), and 5 (7.0%) with immune-mediated necrotizing myopathy (IMNM). Two-step cluster analysis identified 3 distinctive subgroups: Cluster 1 of 15 (51.7%) patients characterized by rash, positive anti-MDA5 antibody and hypoproteinemia ( < 0.05) with normal or slightly elevated CK level, mainly corresponding to CADM; Cluster 2 of 4 (57.1%) patients with significantly elevated CK and positive anti-SRP antibody ( < 0.001) corresponding to IMNM; and Cluster 3 of 17 (48.6%) patients consisting primarily of patients with PM, characterized by positivity for anti- aminoacyl transfer RNA synthetases antibodies (=0.022) corresponding to antisynthetase syndrome (ASS).@*CONCLUSIONS@#Patients with IIM can be divided into 3 subgroups based on their clinical and serological characteristics (especially myositis-specific antibodies), and among them ASS may represent an independent IIM subgroup with unique clinical characteristics.


Subject(s)
Antibodies , Autoantibodies , Dermatomyositis , Humans , Lung Diseases, Interstitial , Myositis , Retrospective Studies
10.
Medwave ; 20(7): e8006, 2020.
Article in English, Spanish | LILACS | ID: biblio-1122649

ABSTRACT

Una de las principales causas de neumonía en niños entre 5 y 15 años es el Mycoplasma pneumoniae, una bacteria que causa manifestaciones clínicas atípicas como la miositis y encefalitis. Reportamos un caso de una niña de cinco años que presentó limitación funcional en extremidades inferiores precedida por una infección respiratoria superior. Posteriormente, se complicó con neumonía y encefalitis. Se administraron antibióticos y antivirales debido al deterioro clínico del paciente. La serología de inmunoglobulinas para Mycoplasma pneumoniae fue positiva; mientras que los demás estudios virales fueron negativos. El curso clínico fue favorable con disminución progresiva de la dificultad respiratoria, trastorno del sensorio y mejoría en la limitación funcional en las extremidades inferiores a los 15 días de tratamiento.


One of the leading causes of pneumonia in children between 5 to 15 years is Mycoplasma pneumoniae, a bacterium that causes atypical clinical manifestations such as myositis and encephalitis. We report a 5-year-old girl who presented functional limitations of the lower extremities preceded by an upper respiratory infection. Later on, she developed pneumonia and encephalitis. Antibiotics and antivirals were administered due to the clinical deterioration of the patient. IgM serology for Mycoplasma pneumoniae was positive, while the other viral studies were negative. The clinical course was favorable with a progressive decrease in respiratory distress, sensorial disorder, and improvement in the functional limitations of the lower limbs after 15 days of treatment.


Subject(s)
Humans , Female , Child, Preschool , Pneumonia, Mycoplasma/diagnosis , Encephalitis/diagnosis , Mycoplasma pneumoniae/isolation & purification , Myositis/diagnosis , Pneumonia, Mycoplasma/microbiology , Pneumonia, Mycoplasma/drug therapy , Acute Disease , Encephalitis/microbiology , Encephalitis/drug therapy , Anti-Bacterial Agents/administration & dosage , Myositis/microbiology , Myositis/drug therapy
11.
Einstein (Säo Paulo) ; 18: eAO5105, 2020. tab, graf
Article in English | LILACS | ID: biblio-1090040

ABSTRACT

ABSTRACT Objective To evaluate the density of anti-galectin-3-immunostained cells, collagen percentage, mast cell density and presence of pathological processes in intestinal muscle biopsies of patients. Methods Thirty-five patients who underwent intestinal biopsy were selected from 1997 to 2015. Patients were divided into three groups: chagasic patients with mucosal lesion (n=13), chagasic patients with intact mucosa (n=12) and non-chagasic patients with no mucosal lesion (n=10). Histological processing of the biopsied fragments and immunohistochemistry for galectin-3 were performed. Additional sections were stained with hematoxylin and eosin to evaluate the general pathological processes, picrosirius for evaluation of collagen and toluidine blue to evaluate the mast cell density. Results Patients of mucosal lesion group had a significantly higher frequency of ganglionitis and myositis when compared to the chagasic patients with intact mucosa and non-chagasic group. The density of anti-galectin-3-immunostained cells was significantly higher in the chagasic patients with intact mucosa group when compared to the non-chagasic group. The group of chagasic patients with intact mucosa presented a higher percentage of collagen in relation to the patients with mucosal lesion and to the non-chagasic group, with a significant difference. There was no significant difference in mast cell density among the three groups. Conclusion The higher density of anti-galectin-3-immunostained cells in patients in the chagasic patients with intact mucosa group suggested the need for greater attention in clinical evaluation of these patients, since this protein is associated with neoplastic transformation and progression.


RESUMO Objetivo Avaliar a densidade de células imunomarcadas por anti-galectina-3, a percentagem de colágeno, a densidade de mastócitos e a presença de processos patológicos na musculatura intestinal de pacientes biopsiados. Métodos Foram selecionados 35 pacientes submetidos à biópsia de intestino entre 1997 a 2015. Os pacientes foram divididos em três grupos: chagásicos com lesão de mucosa (n=13), chagásicos com mucosa íntegra (n=12) e não chagásicos sem lesão de mucosa (n=10). Foram realizados processamento histológico dos fragmentos biopsiados e imunohistoquímica para galectina-3. Cortes adicionais foram corados por hematoxilina e eosina, para avaliar os processos patológicos gerais, pelo picrosírius, para avaliação do colágeno, e pelo azul de toluidina, para avaliar a densidade de mastócitos. Resultados Os pacientes do grupo chagásicos com lesão de mucosa apresentaram frequência significativamente maior de ganglionite e miosite quando comparados aos dos grupos chagásico com mucosa íntegra e não chagásicos. A densidade das células imunomarcadas por anti-galectina-3 foi significativamente maior no grupo chagásicos com mucosa íntegra quando comparada ao grupo não chagásico. O grupo de chagásicos com mucosa íntegra apresentou maior percentagem de colágeno em relação aos grupos chagásicos com mucosa lesada e ao grupo de não chagásicos, com diferença significativa. Não houve diferença significativa com relação à densidade de mastócitos entre os três grupos. Conclusão A maior densidade de células imunomarcadas por anti-galectina-3 nos pacientes do grupo chagásico com mucosa íntegra sugere a necessidade de maior atenção na avaliação clínica desses pacientes, uma vez que essa proteína está associada com transformação e progressão neoplásica.


Subject(s)
Humans , Male , Female , Adult , Aged , Aged, 80 and over , Colonoscopy/methods , Chagas Disease/pathology , Galectin 3/analysis , Intestinal Mucosa/pathology , Megacolon/pathology , Antibodies, Monoclonal/analysis , Biopsy , Fibrosis , Immunohistochemistry , Case-Control Studies , Cell Count , Retrospective Studies , Analysis of Variance , Collagen/analysis , Statistics, Nonparametric , Galectin 3/immunology , Mast Cells/pathology , Middle Aged , Myositis/pathology
12.
Rev. cuba. reumatol ; 22(supl.1): e849, graf
Article in Spanish | LILACS, CUMED | ID: biblio-1280395

ABSTRACT

La incidencia de la miopatía inflamatoria idiopática es de 4 a 15 casos por cada millón de habitantes y su prevalencia de 60 por cada millón de habitantes. La dermatomiositis idiopática es más frecuente en las mujeres, aunque su asociación a fibrosis pulmonar es muy rara y solo se reporta en un 2 por ciento de los casos. Se describe el caso de un paciente de 50 años de edad, femenina, que presentó debilidad a nivel de la cintura escapular acompañada de fatiga. Tenía lesiones de rascado en diferentes regiones del cuerpo por prurito y lesiones eritematosas en la piel en ambos muslos. Además, se quejaba de dolores articulares generalizados con impotencia funcional y mialgias generalizadas progresivas e hipotrofia muscular de varios grupos musculares. El estudio analítico reveló enzimas musculares elevadas. La biopsia de piel y músculo mostró elementos sugestivos de dermatomiositis. Con la espirometría se detectó trastornos ventilatorios restrictivos de grave intensidad. Mediante la radiografía de tórax se halló infiltrado difuso peribroncovascular asociado a un trayecto fibroso y la tomografía axial computarizada precisó el pulmón con consolidación alveolar y discreto engrosamiento pleural. La paciente fue tratada con prednisona a 1 mg/kg/día asociado con azatioprina 1,5 mg/kg/día. Este tratamiento fue muy eficaz, y se logró una notable recuperación clínica y por estudios de laboratorio. Reportamos el caso de una paciente con dermatomiositis idiopática y fibrosis pulmonar. Esta asociación constituye un hallazgo infrecuente en nuestro medio y más aun con el paciente asintomático(AU)


The incidence of Idiopathic Inflammatory Myopathy is from 4 to 15 cases per million inhabitants and its prevalence of 60 per million inhabitants. Idiopathic dermatomyositis is more frequent in women; Although its association with pulmonary fibrosis is described, it is very infrequent, it is only reported in 2 percent of cases. To describe a diagnosed case of idiopathic dermatomyositis and pulmonary fibrosis. A 50-year-old patient presented weakness at the level of the shoulder girdle accompanied by fatigue. Physical examination: Skin: scratching lesions in different regions of the body due to pruritus, erythematous lesions at the level of the skin on both thighs. Osteomyoarticular system: generalized joint pains with functional impotence and progressive generalized myalgias and muscular hypotrophy of several muscle groups. The analytical study revealed elevated muscle enzymes. The skin and muscle biopsy showed elements suggestive of dermatomyositis. Chest X-ray: diffuse peribronchovascular infiltrate associated with fibrous path. Spirometry: restrictive ventilatory disorders of severe intensity. Computed tomography of the lung with alveolar consolidation and discrete pleural thickening. We report the case of a patient with idiopathic dermatomyositis and pulmonary fibrosis. This association is an uncommon finding in our environment and even more so when the patient is asymptomatic(AU)


Subject(s)
Humans , Female , Middle Aged , Spirometry/methods , Azathioprine/therapeutic use , Prednisone/therapeutic use , Dermatomyositis/diagnosis , Myositis/epidemiology , Fatigue
13.
Rev. argent. reumatolg. (En línea) ; 31(1): 12-17, 2020. ilus
Article in Spanish | LILACS, BINACIS | ID: biblio-1123749

ABSTRACT

Las Miopatías Inflamatorias Idiopáticas (MII) son un grupo heterogéneo de enfermedades que se caracterizan por debilidad muscular e inflamación subyacente en la biopsia muscular. Los principales órganos afectados son el músculo, la piel y también puede afectarse el pulmón. Se distinguen dentro de los subtipos clínicos como Polimiositis (PM), Dermatomiositis (DM), DM con la variante Dermatomiositis Clínicamente Amiopática (DMCA), el Síndrome Antisintetasa (SAS), la Miositis Necrotizante Inmunomediada, la Miositis por Cuerpos de Inclusión (MCI) y la Miositis Asociada a Neoplasia. La presencia de ciertos anticuerpos específicos y asociados predispone al desarrollo de manifestaciones clínicas, determinando el pronóstico de la enfermedad. Se presentan 4 pacientes del Registro de MII de la Sociedad Argentina de Reumatología (SAR) con estas características: un paciente con PM y anti Jo-1 positivo y tres pacientes con DM (uno con DMCA y anti- RO 52 y dos pacientes con anti-PL7 y anti-TIF1γ respectivamente).


Idiopathic Inflammatory Myopathies (MII) are a heterogeneous group of diseases characterized by muscle weakness and inflammation underlying muscle biopsy. The main organs affected are muscle, skin and the lung can also be affected. They are distinguished within clinical subtypes such as Polymyositis (PM), Dermatomyositis (DM), DM with the variant Clinically Amiopathic Dermatomyositis (DMCA), the Syndrome Antisynthetase (SAS), Immune-mediated Necrotizing Myositis, Body Myositis Inclusion (MCI) and Neoplasia-Associated Myositis. The presence of certain specific and associated antibodies predisposes to the development of clinical manifestations, determining the disease prognosis. 4 patients from the Registry of MII of the Argentine Society of Rheumatology (SAR) are presented with these characteristics: one patient with PM and anti Jo-1 positive and three patients with DM (one with DMCA and anti-RO 52 and two patients with anti-PL7 and anti-TIF1γ respectively).


Subject(s)
Humans , Myositis , Rheumatology , Dermatomyositis , Lung Diseases
14.
Rev. colomb. reumatol ; 26(4): 268-270, oct.-dic. 2019. graf
Article in English | LILACS | ID: biblio-1138819

ABSTRACT

ABSTRACT Granulomatosis with polyangiitis (GPA) is a systemic vasculitis with multiorgan involvement. Although ocular involvement has frequently been described, there are few reported cases of extraocular myositis in this disease. The case is presented of a Mexican woman with GPA who debuted with extraocular myositis.


RESUMEN La granulomatosis con poliangeítis (GPA) es una vasculitis sistémica con afectación multiorgánica. El compromiso ocular ha sido descrito frecuentemente, sin embargo, existen pocos casos reportados de miositis extraocular en esta enfermedad. Presentamos el caso de una mujer mexicana con GPA que comenzó con miositis extraocular.


Subject(s)
Humans , Female , Middle Aged , Granulomatosis with Polyangiitis , Systemic Vasculitis , Myositis , Inflammation
15.
Arch. argent. pediatr ; 117(5): 493-496, oct. 2019. graf, tab
Article in Spanish | LILACS, BINACIS | ID: biblio-1054969

ABSTRACT

La miositis viral aguda es una complicación posterior a una infección viral causada, principalmente, por virus influenza A y B. Se caracteriza por ser un proceso inflamatorio transitorio, súbito, autolimitado y benigno. Generalmente, afecta a niños preescolares y escolares, que presentan dolor bilateral y sensibilidad en los grupos musculares de los miembros inferiores sin alteración en el examen neurológico. Puede generar alteración de la marcha o de la bipedestación. Su principal complicación es la rabdomiólisis, por lo que se debe hacer un seguimiento clínico y de los valores de la creatinfosfoquinasa. Se presenta el caso de un niño en edad escolar con diagnóstico de miositis viral aguda. Debido a que es poco frecuente y su incidencia en Latinoamérica es desconocida, se considera importante el reporte del caso y la revisión del tema, ya que su curso es benigno, de fácil manejo, y su conocimiento evita estudios y hospitalizaciones innecesarias.


Acute viral myositis is a complication after a viral infection mainly caused by Influenza A and B viruses. It is characterized as a transitory, sudden, self-limiting and benign inflammatory process. It usually affects preschool and school children presenting bilateral pain and sensitivity in the muscle groups of the lower limbs without alteration in the neurological examination. It can affect the gait or standing. The main complication is rhabdomyolysis, which is why clinical followup and values of creatine phosphokinase must be done. We present the case of a school-age child diagnosed with acute viral myositis. Because it is not a frequent entity and its incidence in Latin America is unknown, we consider important to report the case and review the topic, as its clinical course is benign, easily treated, and its knowledge can avoid unnecessary studies and hospitalizations.


Subject(s)
Humans , Male , Child , Myositis/diagnosis , Rhabdomyolysis , Virus Diseases , Gait Apraxia , Myositis/complications , Myositis/therapy
17.
Acta pediátr. hondu ; 10(1): 1011-1020, abr.-sept. 2019. ilus, tab
Article in Spanish | LILACS | ID: biblio-1050914

ABSTRACT

1011RESUMENLa Dermatopolimiositis (DPM) pertenece a las miopatías inflamatorias idiopáticas (MII), un grupo heterogéneo de miopatías autoin-munitarias sistémicas crónicas, asociadas con una alta morbilidad y discapacidad funcional. Comprende aquellas entidades de naturaleza adquirida que cursan con debilidad muscular y presentan de forma característica un infiltrado inflamatorio y necrosis celular en el tejido muscular estria-do. Es una enfermedad rara, con una inci-dencia global de 2­10 casos por millón de habitantes/año. Presentamos el caso de adolescente masculino de 14 años con antecedente de dermatomiositis, el cual presenta debilidad muscular proximal progresiva, acompañado de mialgias inten-sas e incapacitantes, presencia de eritema en heliotropo y pápulas de Gottron. Estu-dios laboratoriales que evidenciaron anemia, alteraciones enzimáticas, reactan-tes de fase aguda alterados, estudio electromiográfico que evidenció la presen-cia de polimiositis reactiva, y biopsia de tejido muscular que reportó cambios compatibles con DPM. El diagnóstico de miopatías inflamatorias se sospecha sobre la base de un conjunto de signos y síntomas y es confirmado mediante estudios comple-mentarios, entre los que se incluyen: eleva-ción de enzimas musculares, presencia de autoanticuerpos específicos de miositis,Dermatopolymyositis in adolescent patient. Case reportDermatopolimiositis en paciente adolescente. Reporte de casoelectromiografía con patrón miopático, hallazgos específicos en la biopsia. La PDM en niños tiene un comportamiento clínico diferente al adulto por la presencia vasculi-tis, existiendo varios desordenes que pueden confundir esta entidad y retardar su diagnóstico y tratamiento, por lo tanto, es muy importante el conocimiento de esta enfermedad en la edad pediátrica y estable-cer comparaciones con lo reportado en la literatura mundial...(AU)


Subject(s)
Humans , Male , Adolescent , Muscle Weakness , Dermatomyositis/diagnosis , Myositis/complications , Erythema
18.
Rev. méd. Chile ; 147(3): 342-355, mar. 2019. tab, graf
Article in Spanish | LILACS | ID: biblio-1004355

ABSTRACT

Idiopathic inflammatory myopathies (IIM) are a heterogeneous group of acquired immune-mediated diseases, which typically involve the striated muscle with a variable involvement of the skin and other organs. Clinically, they are characterized by proximal muscle weakness, elevation of muscle enzymes, myopathic changes on electromyography and an abnormal muscle biopsy. The different IIM have been classified according to their distinctive histopathologic features in dermatomyositis (DM), polymyositis (PM), inclusion body myositis (IBM) and immune-mediated necrotizing myopathy (IMNM). Several myositis-specific antibodies are associated with the different phenotypes, as well as with different risk of neoplastic disease and systemic complications. The basis for the treatment of DM, PM, and IMNM is immunosuppression. For IBM there are only symptomatic treatments. Steroids, associated or not with other immunosuppressant drugs, are the first line of treatment. Biologic drugs will allow future individualized therapies. The 10-year survival of DM, PM and IMNM is 62 to 90%. The leading causes of death are neoplastic, lung and cardiac complications. IBM does not impair survival, although it affects the quality of life.


Subject(s)
Humans , Myositis/pathology , Polymyositis/pathology , Muscle, Skeletal/pathology , Dermatomyositis/pathology , Electromyography , Immunosuppressive Agents/classification , Immunosuppressive Agents/therapeutic use , Antibodies , Myositis/drug therapy
19.
Rev. colomb. reumatol ; 26(1): 63-67, Jan.-Mar. 2019. graf
Article in English | LILACS | ID: biblio-1098967

ABSTRACT

ABSTRACT Polyarteritis nodosa is part of the primary systemic vasculitis that specifically compromises vessels of medium caliber, and can affect virtually any organ. The diagnosis of this disease is based on clinical criteria, such as pain and weakness in the lower limbs, as well as laboratory results and the histology report that shows necrotizing, segmental and focal inflammation of the vessels involved. The case is presented of a 42 year-old woman with a previous diagnosis of polyarteritis nodosa, who, 12 years later, presented with an episode of activation of the disease associated with venous thrombosis and multifocal myopathy in the lower limbs. This is a rare presentation that should be suspected in this type of patients.


RESUMEN La poliarteritis nodosa hace parte de las vasculitis sistémicas primarias, específicamente compromete vasos de mediano calibre pudiendo afectar virtualmente a cualquier órgano. El diagnóstico de esta enfermedad se basa en criterios clínicos, como el dolor y la debilidad en los miembros inferiores, además de reportes paraclínicos y el compromiso histológico, que evidencia inflamación necrosante, segmentaria y focal de los vasos involucrados. A continuación, presentamos el caso clínico de una mujer de 42 arios, con diagnóstico previo de poliarteritis nodosa, que presenta, 12 años después, un episodio de activación de la enfermedad asociado a trombosis venosa y miopatía multifocal en miembros inferiores, una presentación poco frecuente pero que debe sospecharse en este tipo de pacientes.


Subject(s)
Humans , Female , Adult , Polyarteritis Nodosa , Vasculitis , Magnetic Resonance Spectroscopy , Diagnosis , Histology , Muscular Diseases , Myositis
20.
Rev. colomb. reumatol ; 26(1): 58-62, Jan.-Mar. 2019. tab
Article in English | LILACS | ID: biblio-1098966

ABSTRACT

ABSTRACT Pompe disease, or glycogen storage disease type II, is an autosomal recessive disorder due to the deficiency of lysosomal acid α-glucosidase, the enzyme responsible for degrading glycogen to glucose. The adult-onset form is rare and is characterized, primarily by accumulation of glycogen in striated, cardiac, and smooth muscle tissue. It causes muscle weakness of proximal predominance, so it can be confused with an inflammatory myopathy. The case is presented of a 60 year-old adult with a previous diagnosis of polymyositis in whom Pompe disease was confirmed with a demonstration of the enzymatic deficit in a biological substrate and a genetic identification was obtained.


RESUMEN La enfermedad de Pompe o glucogenosis tipo n es un trastorno autosómico recesivo, debido a la deficiencia de la enzima lisosomal α-glucosidasa ácida encargada de degradar glucógeno a glucosa. La forma de inicio en el adulto es rara y se caracteriza fundamentalmente por acumulación de glucógeno en tejido muscular estriado, cardiaco y liso. Causa debilidad muscular de predominio proximal, por lo que se puede confundir con una miopatía inflamatoria. Se presenta el caso de un adulto de 60 arios con diagnóstico previo de polimiositis, en quien se confirmó una enfermedad de Pompe con demostración del déficit enzimático en sustrato biológico y se logró realizar una identificación genética.


Subject(s)
Humans , Male , Middle Aged , Glycogen Storage Disease Type II , Myositis , Muscle Weakness , Diagnosis
SELECTION OF CITATIONS
SEARCH DETAIL