Eosinophilic perimyositis as the presenting feature of a monoclonal T-cell expansion

Details

Serval ID
serval:BIB_024D14F28AC3
Type
Article: article from journal or magazin.
Publication sub-type
Case report (case report): feedback on an observation with a short commentary.
Collection
Publications
Institution
Title
Eosinophilic perimyositis as the presenting feature of a monoclonal T-cell expansion
Journal
Muscle and Nerve
Author(s)
Dunand  M., Lobrinus  J. A., Spertini  O., Kuntzer  T.
ISSN
0148-639X (Print)
Publication state
Published
Issued date
05/2005
Peer-reviewed
Oui
Volume
31
Number
5
Pages
646-651
Language
english
Notes
Case Reports Journal Article --- Old month value: May
Abstract
A 51-year-old physically active man was investigated for exertional myalgias and muscle stiffness. On examination he had mild proximal muscle weakness of the upper extremities and retraction of the digit flexors. Blood eosinophilia was present, but serum creatine kinase (CK) levels and an electromyographic study were normal. A skin-fascia-muscle biopsy of the calf revealed a macrophagic and CD4+ T-cell infiltration of the perimysium, and a T-cell expansion was observed in blood, bone marrow, and muscle. A diagnosis of eosinophilic perimyositis was made, and prednisone and azathioprine were administrated with a good clinical response. This case highlights the differential diagnosis of blood eosinophilia with muscle disorders, and underscores that eosinophilic perimyositis may be the expression of a T-cell monoclonal expansion. Although the pathogenesis behind the T-cell expansion is unclear but probably inflammatory, we suggest regular follow-up to allow early treatment of any T-cell lymphoproliferative malignancy that may develop.
Keywords
Arm/physiopathology CD4-Positive T-Lymphocytes/pathology Clone Cells/immunology/pathology Diagnosis, Differential Eosinophilia-Myalgia Syndrome/etiology/pathology/*physiopathology Eosinophils/pathology Humans Lymphoproliferative Disorders/*complications/diagnosis/physiopathology Macrophages/pathology Male Middle Aged Muscle Weakness/etiology/pathology/physiopathology Muscle, Skeletal/pathology/*physiopathology Myositis/etiology/pathology/*physiopathology T-Lymphocytes/immunology/*pathology
Pubmed
Web of science
Create date
25/01/2008 15:31
Last modification date
20/08/2019 12:24
Usage data