Toxoplasmic myositis as a presenting manifestation of idiopathic CD4 lymphocytopenia

Muscle Nerve. 2003 Jun;27(6):761-5. doi: 10.1002/mus.10376.

Abstract

Toxoplasma gondii encysts in skeletal muscle. Although only rarely found at muscle biopsy, this parasite has previously been regarded as a possible cause of polymyositis. We report a case of biopsy-proven toxoplasmic myositis in a non-HIV-infected patient that led to recognition of idiopathic CD4 lymphocytopenia (ICL), a rare condition typically associated with opportunistic infections. Interestingly, the CD25(+) subset that corresponds to the CD4(+) regulatory T cells controlling autoimmune processes was lacking. Steroid and antiprotozoal therapy led to recovery.

Publication types

  • Case Reports

MeSH terms

  • Animals
  • CD3 Complex / metabolism
  • CD4 Lymphocyte Count
  • HLA-DR Antigens / blood
  • Humans
  • Male
  • Middle Aged
  • Muscle, Skeletal / immunology
  • Muscle, Skeletal / parasitology*
  • Muscle, Skeletal / physiopathology
  • Myositis / immunology
  • Myositis / parasitology*
  • Myositis / physiopathology
  • Opportunistic Infections / immunology
  • Opportunistic Infections / parasitology*
  • Opportunistic Infections / physiopathology
  • T-Lymphocytopenia, Idiopathic CD4-Positive / complications*
  • T-Lymphocytopenia, Idiopathic CD4-Positive / immunology
  • T-Lymphocytopenia, Idiopathic CD4-Positive / physiopathology
  • Toxoplasma / cytology
  • Toxoplasma / immunology
  • Toxoplasmosis / complications*
  • Toxoplasmosis / immunology
  • Toxoplasmosis / physiopathology

Substances

  • CD3 Complex
  • HLA-DR Antigens