Macrophagic myofasciitis in a 3-month-old child

Abstract

Macrophagic myofasciitis (MMF) is a rare inflammatory myopathy which occurs after injection of aluminium-containing vaccines against hepatitis B virus (HBV), hepatitis A virus, and tetanus toxoid. Most of the cases reported are from France and are adult patients. We report a rare case of MMF in a 3-month-old male child of Indian origin. He was immunized for HBV at birth after which he developed generalized hypotonia, and central nervous system and peripheral nervous system manifestations at 1 month of age. Muscle biopsy showed typical features of MMF and aluminium could be detected in the muscle biopsy macrophages by ultrastructural examination and LAMMA technique. Our case is the youngest case of MMF and one of few from Asia. (J Pediatr Neurol 2004; 2(4): 225?229).

Childhood macrophagic myofasciitis: A series from the Indian subcontinent

“…The deltoid muscle was the biopsy site as well as the site for vaccination; HBV vaccine accounted for 84% of cases . Pediatric cases of MMF are rare, as <50 cases have been reported . The clinical presentation of MMF in children is nonspecific, with most presenting with hypotonia or motor delay, as in our series .…”

“…Most reported cases of MMF have been from Europe, particularly France, with a few from the United States. However, there is a paucity of reports of MMF from Asia, with only a few case reports describing a single case each . The vast majority of patients diagnosed with MMF are adults, which is unusual considering that most vaccines are administered in childhood.…”

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“…The plant biomass in its unprocessed state, is characterized by low bulk density, making its transport, storage and practical use difficult. For these reasons, there is a need for its agglomeration in the form of pellets or briquettes [4][5][6][7]. These biofuels are made of finely fragmented biomass under the influence of suitable pressure and temperature, most often without the addition of any binder.…”

Myalgia and chronic fatigue syndrome following immunization: macrophagic myofasciitis and animal studies support linkage to aluminum adjuvant persistency and diffusion in the immune system

“…For example, only 10% of adult muscle biopsies have been performed in the deltoid muscle in one US center, MMF being detected in 1% of these biopsies [14]. Despite the usual routine choice of an incongruent biopsy site precluding detection of most MMF cases, the lesion could be occasionally documented in Australia [71], Brazil [72], Germany [73][74][75][76],…”