An atypical case of focal myositis

Detalhes bibliográficos
Autor(a) principal: Silva, Ana Bento da
Data de Publicação: 2022
Outros Autores: Torres, Rita Pinheiro, Lourenço, Maria Helena, Cabral, Catarina, Reis, Rita, Cunha-Branco, Jaime, Gonçalves, Maria João
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: http://hdl.handle.net/10400.21/16431
Resumo: A 64-year-old woman presented with a 10-day history of painful progressive bilateral temporal and right retroauricular region tumefaction, dysphonia, and a body temperature of 37.5°C. She had been previously prescribed antibiotics assuming an oral infection, with no benefit. She had no other complaints and her past medical history and clinical exam were otherwise unremarkable. Her labs revealed high levels of CRP (11.7 mg/dl), ESR (52 mm/h), creatine kinase (CK 623 U/l), myoglobin (83 U/l), aspartate transaminase (56 U/l) and alanine transaminase (69 U/l). Serologies were negative for Treponema pallidum, human immunodeficiency, hepatitis B and C, and Epstein–Barr viruses; blood cultures and immunological study, including anti-nuclear antibodies and antibodies associated with inflammatory myopathies, were negative. A facial MRI revealed thickening and T2/FLAIR hypersignal of the temporal, masseter, and pterygoid muscles with signal intensification after gadolinium injection, suggesting myositis. A temporal muscle biopsy showed marked lymphocyte infiltration (predominantly lymphocyte T CD3), as well as the marking of multiple fibres with major histocompatibility complex class I products, which supported the diagnosis. Prednisolone 0.5 mg/kg/day (30 mg) was started, with marked clinical improvement and normalization of CRP, ESR, and CK.
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spelling An atypical case of focal myositisMasticatory musclesMyositisFocal myositisA 64-year-old woman presented with a 10-day history of painful progressive bilateral temporal and right retroauricular region tumefaction, dysphonia, and a body temperature of 37.5°C. She had been previously prescribed antibiotics assuming an oral infection, with no benefit. She had no other complaints and her past medical history and clinical exam were otherwise unremarkable. Her labs revealed high levels of CRP (11.7 mg/dl), ESR (52 mm/h), creatine kinase (CK 623 U/l), myoglobin (83 U/l), aspartate transaminase (56 U/l) and alanine transaminase (69 U/l). Serologies were negative for Treponema pallidum, human immunodeficiency, hepatitis B and C, and Epstein–Barr viruses; blood cultures and immunological study, including anti-nuclear antibodies and antibodies associated with inflammatory myopathies, were negative. A facial MRI revealed thickening and T2/FLAIR hypersignal of the temporal, masseter, and pterygoid muscles with signal intensification after gadolinium injection, suggesting myositis. A temporal muscle biopsy showed marked lymphocyte infiltration (predominantly lymphocyte T CD3), as well as the marking of multiple fibres with major histocompatibility complex class I products, which supported the diagnosis. Prednisolone 0.5 mg/kg/day (30 mg) was started, with marked clinical improvement and normalization of CRP, ESR, and CK.Oxford AcademicRCIPLSilva, Ana Bento daTorres, Rita PinheiroLourenço, Maria HelenaCabral, CatarinaReis, RitaCunha-Branco, JaimeGonçalves, Maria João2023-08-30T11:34:22Z2022-052022-05-01T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/10400.21/16431engSilva AB, Torres RP, Lourenço MH, Cabral C, Reis R, Gonçalves MJ, et al. An atypical case of focal myositis. Rheumatology. 2022;61(6):e158-9.10.1093/rheumatology/keab574info:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2023-09-06T02:15:53Zoai:repositorio.ipl.pt:10400.21/16431Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T20:28:19.759125Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv An atypical case of focal myositis
title An atypical case of focal myositis
spellingShingle An atypical case of focal myositis
Silva, Ana Bento da
Masticatory muscles
Myositis
Focal myositis
title_short An atypical case of focal myositis
title_full An atypical case of focal myositis
title_fullStr An atypical case of focal myositis
title_full_unstemmed An atypical case of focal myositis
title_sort An atypical case of focal myositis
author Silva, Ana Bento da
author_facet Silva, Ana Bento da
Torres, Rita Pinheiro
Lourenço, Maria Helena
Cabral, Catarina
Reis, Rita
Cunha-Branco, Jaime
Gonçalves, Maria João
author_role author
author2 Torres, Rita Pinheiro
Lourenço, Maria Helena
Cabral, Catarina
Reis, Rita
Cunha-Branco, Jaime
Gonçalves, Maria João
author2_role author
author
author
author
author
author
dc.contributor.none.fl_str_mv RCIPL
dc.contributor.author.fl_str_mv Silva, Ana Bento da
Torres, Rita Pinheiro
Lourenço, Maria Helena
Cabral, Catarina
Reis, Rita
Cunha-Branco, Jaime
Gonçalves, Maria João
dc.subject.por.fl_str_mv Masticatory muscles
Myositis
Focal myositis
topic Masticatory muscles
Myositis
Focal myositis
description A 64-year-old woman presented with a 10-day history of painful progressive bilateral temporal and right retroauricular region tumefaction, dysphonia, and a body temperature of 37.5°C. She had been previously prescribed antibiotics assuming an oral infection, with no benefit. She had no other complaints and her past medical history and clinical exam were otherwise unremarkable. Her labs revealed high levels of CRP (11.7 mg/dl), ESR (52 mm/h), creatine kinase (CK 623 U/l), myoglobin (83 U/l), aspartate transaminase (56 U/l) and alanine transaminase (69 U/l). Serologies were negative for Treponema pallidum, human immunodeficiency, hepatitis B and C, and Epstein–Barr viruses; blood cultures and immunological study, including anti-nuclear antibodies and antibodies associated with inflammatory myopathies, were negative. A facial MRI revealed thickening and T2/FLAIR hypersignal of the temporal, masseter, and pterygoid muscles with signal intensification after gadolinium injection, suggesting myositis. A temporal muscle biopsy showed marked lymphocyte infiltration (predominantly lymphocyte T CD3), as well as the marking of multiple fibres with major histocompatibility complex class I products, which supported the diagnosis. Prednisolone 0.5 mg/kg/day (30 mg) was started, with marked clinical improvement and normalization of CRP, ESR, and CK.
publishDate 2022
dc.date.none.fl_str_mv 2022-05
2022-05-01T00:00:00Z
2023-08-30T11:34:22Z
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv http://hdl.handle.net/10400.21/16431
url http://hdl.handle.net/10400.21/16431
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv Silva AB, Torres RP, Lourenço MH, Cabral C, Reis R, Gonçalves MJ, et al. An atypical case of focal myositis. Rheumatology. 2022;61(6):e158-9.
10.1093/rheumatology/keab574
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
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dc.publisher.none.fl_str_mv Oxford Academic
publisher.none.fl_str_mv Oxford Academic
dc.source.none.fl_str_mv reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
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