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Neuropediatrics 2009; 40(4): 174-178
DOI: 10.1055/s-0029-1243172
Original Article

© Georg Thieme Verlag KG Stuttgart · New York

Macrophagic Myofasciitis Plus (Distinct Types of Muscular Dystrophy)

H. D. Müller1 , F. K. H. van. Landeghem2 , 4 , P. F. Schmidt3 , C. Sommer1 , H. H. Goebel1 , 2
  • 1Department of Neuropathology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
  • 2Institute of Neuropathology, Charité Universitätsmedizin, Berlin, Germany
  • 3Institute of Legal Medicine, Westphalian Wilhelms University, Münster, Germany
  • 4Present address: Institute of Neuropathology, University of Bonn Medical Center, Bonn, Germany
Further Information

Publication History

received 23.06.2009

accepted 19.10.2009

Publication Date:
04 February 2010 (online)

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Abstract

Macrophagic myofasciitis (MMF) is a well-known lesion following vaccination with aluminium-containing vaccines. It has abundantly been reported in adults and several times in children, often in single patients or in rather small cohorts. Only few of these published reports on children have shown distinct myopathology of another neuromuscular disease except for MMF. Indications for biopsy often were nondescript clinical features in children, such as hypotonia or delay in motor development but, apparently, never that of suspected MMF. Thus, in previous reports as well as in our two patients, encountering MMF in the biopsied tissue specimens was coincidental. Our two unrelated patients with MMF also had two separate types of muscular dystrophy, a merosinopathy and dystrophinopathy, showing a combination of myopathologically well-defined neuromuscular diseases, muscular dystrophies and MMF. Detecting such a combination of two separate conditions may, in the future, be rare when non-invasive techniques, e. g., genetic, will have replaced muscle biopsy in ascertaining hereditary neuromuscular conditions, especially in children.

Key words

muscular dystrophy - macrophagic myofasciitis - aluminium - immunohistochemistry

References

  • 1 Amoura Z, Costedoat N, Maisonobe T. et al . Familial macrophagic myofasciitis.  Ann Rheum Dis. 2000;  59 927-928
    PubMedSearch in Google Scholar
  • 2 Authier FJ, Gherardi RK. Macrophage mediated myofasciitis: current state of knowledge.  Rev Neurol (Paris). 2007;  163 985-993
    CrossrefPubMedSearch in Google Scholar
  • 3 Bodi I, Buk S, Hughes E. et al .Broadening the spectrum of macrophagic myofasciitis – paediatic and elderly cases (abstract: sy 2-05/P G-03). 8th European Congress of Neuropathology. 25–28 June 2005, Amsterdam, The Netherlands 2005
    PubMedSearch in Google Scholar
  • 4 Di Muzio A, Capasso M, Verrotti A. et al . Macrophagic myofasciitis: An infantile Italian case.  Neuromuscul Disord. 2004;  14 175-177
    CrossrefPubMedSearch in Google Scholar
  • 5 Doostkam S, Bohl J, Schmidt PF. et al . Macrophagic myofasciitis.  Acta Neuropathol. 2005;  110 324 (abstract)
    PubMedSearch in Google Scholar
  • 6 Gherardi RK, Authier FJ. Aluminum inclusion macrophagic myofasciitis: A recently identified condition.  Immunol Allergy Clin North Am. 2003;  23 699-712
    CrossrefPubMedSearch in Google Scholar
  • 7 Gherardi RK, Coquet M, Chérin P. et al . Macrophagic myofasciitis: An emerging entity.  Lancet. 1998;  352 347-352
    CrossrefPubMedSearch in Google Scholar
  • 8 Goebel HH, Schmidt PF, Bohl J. et al . Polyneuropathy due to acute arsenic intoxication: Biopsy studies.  J Neuropathol Exp Neurol. 1990;  49 137-149
    CrossrefPubMedSearch in Google Scholar
  • 9 Gruis KL, Teener JW, Blaivas M. Pediatric macrophagic myofasciitis associated with motor delay.  Clin Neuropathol. 2006;  25 172-179
    PubMedSearch in Google Scholar
  • 10 Kalil RK, Monteiro Jr A, Lima MI. et al . Macrophagic myofasciitis in childhood: The role of scanning electron microscopy/energy-dispersive spectroscopy for diagnosis.  Ultrastruct Pathol. 2007;  31 45-50
    CrossrefPubMedSearch in Google Scholar
  • 11 Lach B, Cupler EJ. Macrophagic myofasciitis in children is a localized reaction to vaccination.  J Child Neurol. 2008;  23 614-619
    CrossrefPubMedSearch in Google Scholar
  • 12 Lacson AG, D'Cruz CA, Gilbert-Barness E. et al . Aluminum phagocytosis in quadriceps muscle following vaccination in children: relationship to macrophagic myofasciitis.  Pediatr Dev Pathol. 2002;  5 151-158
    CrossrefPubMedSearch in Google Scholar
  • 13 Mrak RE. Muscle granulomas following intramuscular injection.  Muscle Nerve. 1982;  5 637-639
    CrossrefPubMedSearch in Google Scholar
  • 14 Müller HD, van Landeghem FKH, Sommer C. et al . Macrophagic myofasciitis (MMF) plus: Distinct types of muscular dystrophy (MD) [abstract 43]. 53rd Annual Meeting of the German Society of Neuropathology and Neuroanatomy. Würzburg/Germany (October 9–11, 2008).  Acta Neuropathol. 2008;  16 351
    PubMedSearch in Google Scholar
  • 15 Nevo Y, Kutai M, Jossiphov J. et al . Childhood macrophagic myofasciitis – consanguinity and clinicopathological features.  Neuromuscul Disord. 2004;  14 246-252
    CrossrefPubMedSearch in Google Scholar
  • 16 Papo T. Macrophagic myofasciitis: focal or systemic?.  Joint Bone Spine. 2003;  70 242-245
    CrossrefPubMedSearch in Google Scholar
  • 17 Rivas E, Gomez-Arnaiz M, Ricoy JR. et al . Macrophagic myofasciitis in childhood: A controversial entity.  Pediatr Neurol. 2005;  33 350-356
    CrossrefPubMedSearch in Google Scholar
  • 18 Sharma MC, Prentice A, Schmidt PF. et al . Macrophagic myofasciitis in a 3-month-old child.  J Pediatr Neurol. 2004;  2 225-229
    PubMedSearch in Google Scholar
  • 19 Specht CS, Katus MC, Kalasinsky VF. et al . Macrophagic myofasciitis – histochemical, immunohistochemical and spectroscopic findings in a pediatric case (abstract 558.6).  J Neuropathol Exp Neurol. 2007;  66 450
    PubMedSearch in Google Scholar

Correspondence

Dr. Harald D. MüllerMD 

Department of Neuropathology

University Medical Center of the Johannes Gutenberg University

Mainz

Langenbeckstr. 1

55131 Mainz

Germany

Phone: +49/6131/174 332

Fax: +49/6131/176 606

Email: mueller@neuropatho.klinik.uni-mainz.de