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REVIEW PAPER
Macrophagic myofasciitis: an atypical presentation for a rare disease with a challenging approach
1
Internal Medicine Department, Oporto University Hospital Center, Portugal
2
Clinical Immunology Unit, Oporto University Hospital Center, Portugal
3
Unit for Multidisciplinary Research in Biomedicine (UMIB) – ICBAS, Oporto University, Portugal
4
Abel Salazar Institute of Biomedical Sciences (ICBAS), Oporto University, Portugal
Submission date: 2020-02-21
Final revision date: 2020-05-23
Acceptance date: 2020-06-02
Online publication date: 2020-06-29
Publication date: 2020-06-29
Reumatologia 2020;58(3):167-172
KEYWORDS
TOPICS
Scleroderma, myositis and related syndromes - aetiology, pathogenesis, clinical features and treatmentNew therapies in rheumatic diseasesDiagnostics and imaging in rheumatic diseases
ABSTRACT
Macrophagic myofasciitis (MMF) is a rare immune-mediated myopathy that seems to be triggered by aluminium hydroxide adjuvant used in vaccines. Its presentation is relatively heterogeneous and treatment with steroids leads to improvement, although there is little evidence regarding the role of other immunosuppressants. The histological findings in MMF seem to be the result of an abnormal presence in the inoculation site of aluminium, which can induce an immune-mediated muscular disease in susceptible persons. The authors describe the case of a patient with an atypical presentation of macrophagic myofasciitis, with histological confirmation in a muscle biopsy distant from the inoculation site, and a good therapeutic response to tacrolimus and mycophenolate mofetil, as well as a discussion on the pathologic basis, controversies and emerging treatments for this condition.
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Copyright: © Narodowy Instytut Geriatrii, Reumatologii i Rehabilitacji w Warszawie. This is an Open Access journal, all articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0) License (https://creativecommons.org/licenses/by-nc-sa/4.0/), allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited and states its license.
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