Macrophagic myofascitis associated with rheumatoid arthritis

Rheumatol Int. 2010 May;30(7):987-9. doi: 10.1007/s00296-009-1015-3. Epub 2009 Jun 19.

Abstract

Macrophagic myofascitis (MMF) is an unusual inflammatory myopathy characterized by muscle infiltration by macrophages and lymphocytes. Here, we describe a case of MMF which is associated with rheumatoid arthritis. A 53-year-old Japanese rheumatoid arthritis (RA) patient presented with focal tenderness of lower extremities. Magnetic resonance imaging showed evidence of myofascitis involving fascias of anterior tibialis muscle. Muscle biopsy showed a unique pathological pattern of MMF. MMF is known to be associated with vaccination containing aluminum. However, our case was not related to aluminum containing vaccinations and etiologies are unknown. The possible link needs to be discussed.

Publication types

  • Case Reports

MeSH terms

  • Arthritis, Rheumatoid / complications*
  • Biopsy
  • Fascia / immunology
  • Fascia / pathology
  • Fascia / physiopathology
  • Female
  • Gait Disorders, Neurologic / etiology
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Leg / pathology
  • Leg / physiopathology
  • Macrophages / pathology*
  • Magnetic Resonance Imaging
  • Middle Aged
  • Muscle Weakness / etiology
  • Muscle, Skeletal / immunology
  • Muscle, Skeletal / pathology
  • Muscle, Skeletal / physiopathology
  • Myofascial Pain Syndromes / immunology*
  • Myofascial Pain Syndromes / pathology*
  • Myofascial Pain Syndromes / physiopathology
  • Myositis / immunology*
  • Myositis / pathology*
  • Myositis / physiopathology
  • Prednisolone / therapeutic use
  • Tacrolimus / therapeutic use
  • Treatment Outcome

Substances

  • Immunosuppressive Agents
  • Prednisolone
  • Tacrolimus