en POLSKI
eISSN: 2084-9834
ISSN: 0034-6233
Reumatologia/Rheumatology
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3/2020
vol. 58
 
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abstract:
Review paper

Macrophagic myofasciitis: an atypical presentation for a rare disease with a challenging approach

Rita Dias
1
,
Raquel Faria
2, 3
,
Diogo Ribeiro
4
,
Carlos Vasconcelos
2, 3

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
Reumatologia 2020; 58, 3: 167-172
Online publish date: 2020/06/29
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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.
keywords:

macrophagic myofasciitis, vaccines, aluminium hydroxide adjuvant, tacrolimus, mycophenolate mofetil, ASIA







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