Parasitic infections and myositis

El-Beshbishi, Samar N.; Ahmed, Nairmen N.; Mostafa, Samar H.; Elganainy, Goman

doi:10.1007/s00436-011-2609-8

Cited by 31 publications

(17 citation statements)

References 225 publications

(252 reference statements)

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“…Bei Toxoplasmose, einer verwandten Parasitose, wirkt Pyrimethamin plus Sulfadiazin am effektivsten gegen Tachyzoiten, jedoch nicht gegen die späteren, enzystierten Bradyzoiten [5,28,31]. Für die seltene Toxoplasmose-Polymyositis wurde in der Akutphase ein Effekt der Antiprotozontherapie beschrieben, während die chronische Phase eine Steroidgabe erforderte [4,7]. Cotrimoxazol erscheint daher im frühen Stadium therapeutisch erfolgversprechend.…”

Section: Zusammenfassung ▼unclassified

Muskuläre Sarkozystose nach Malaysiareise: eine Fallserie aus Deutschland

Slesak¹,

Tappe

Keller

et al. 2014

Dtsch med Wochenschr

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Muscular sarcocystosis develops in a biphasic pattern with initial fever and later prolonged myalgia, eosinophilia, and CK-elevation. Steroids achieve symptomatic relief in the late phase. Early cotrimoxazole-therapy could possibly prevent parasitic muscle invasion. In fever after travel to Malaysia differential diagnosis should include sarcocystosis. The source of infection appears to be located in North-West of Tioman. Further studies are needed, including addressing early diagnosis and treatment.

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Section: Zusammenfassung ▼unclassified

Muskuläre Sarkozystose nach Malaysiareise: eine Fallserie aus Deutschland

Slesak¹,

Tappe

Keller

et al. 2014

Dtsch med Wochenschr

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“…Treatment of underlying bacterial or fungal infections can often lead to acute recovery (1). However, for many viruses and parasites, poor druggability and effective immune evasion results in chronic infection and long-term myopathy (1, 5–7). Furthermore, while some pathogens can directly cause skeletal muscle damage, previous studies, in other sites of infection, have shown that infection can lead to immunologic scarring and reprogramming that potentiates aberrant immune-mediated pathology (8).…”

Section: Introductionmentioning

confidence: 99%

Therapeutic Administration of IL-10 and Amphiregulin Alleviates Chronic Skeletal Muscle Inflammation and Damage Induced by Infection

2018

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Maintenance of tissue integrity in skeletal muscle requires the immunomodulatory and regenerative functions of muscle-resident regulatory T cells (Tregs). Chronic skeletal muscle infections, such as with Toxoplasma gondii disrupt normal immuno-regulatory networks and lead to pathogenic changes in Treg function. Specifically, Tregs during chronic T. gondii infection reinforce an inflammatory macrophage bias that exacerbates injury in skeletal muscle. In this study, we investigated whether the aberrations in skeletal muscle Treg function during chronic infection could be overcome by treatment with Treg-related factors associated with enhanced muscle regeneration during sterile injury. We show treatment of chronically infected mice with the Treg promoting therapies, interleukin-2 complexed with anti-IL-2 antibody or interleukin-33 (IL-33), did not restore macrophage dynamics or muscle function, respectively, in vivo. However supplementation of known Treg-derived factors, interleukin-10 (IL-10) and amphiregulin (Areg) improved muscle function and skewed macrophages toward a restorative phenotype in the presence of chronic infection. These shifts in macrophage phenotype are coupled with enhanced physiologic parameters of regeneration. Together, these data suggest that while Treg-mediated immuno-regulation is compromised during chronic skeletal muscle infection, supplementation of canonical Treg-derived factors such as IL-10 and Areg can restore immunologic balance and enhance muscle repair.

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“…Myositis with eosinophilic infiltrates most commonly involves parasites [ 17 , 21 ] ( Trichinella , Echinococcus , Taenia solium , and Toxoplasma gondii ), viruses (EBV and coxsackie), inflammatory myopathies (dermatomyositis, polymyositis), and systemic diseases (Churg-Strauss syndrome) [ 13 ]. Other less common etiologies like muscular dystrophies (calpainopathy [ 8 ] and Becker Disease [ 14 ]), toxic exposures to L-tryptophan [ 7 ], toxic oil syndrome, malignancy, and EM as a component of idiopathic hypereosinophilic syndrome (HES) can also have eosinophilic predominant myositis [ 13 ].…”

Section: Discussionmentioning

confidence: 99%

Severe Rhabdomyolysis without Systemic Involvement: A Rare Case of Idiopathic Eosinophilic Polymyositis

Farooq

Choksi

Chu

et al. 2015

Case Reports in Rheumatology

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Introduction. Eosinophilic polymyositis (EPM) is a rare cause of rhabdomyolysis characterized by eosinophilic infiltrates in the muscle. We describe the case of a young patient with eosinophilic polymyositis causing isolated severe rhabdomyolysis without systemic involvement. Case Presentation. A 22-year-old Haitian female with no past medical history presented with progressive generalized muscle aches without precipitating factors. Examination of the extremities revealed diffuse muscle tenderness. Laboratory findings demonstrated peripheral eosinophilia and high creatinine phosphokinase (CPK) and transaminase levels. Workup for the common causes of rhabdomyolysis were negative. Her CPK continued to rise to greater than 100,000 units/L so a muscle biopsy was performed which showed widespread eosinophilic infiltrate consistent with eosinophilic polymyositis. She was started on high dose systemic corticosteroids with improvement of her symptoms, eosinophilia, and CPK level. Discussion. This case illustrates a systematic workup of rhabdomyolysis in the presence of peripheral eosinophilia. Many differential diagnoses must be considered before establishing a diagnosis of idiopathic eosinophilic polymyositis. To our knowledge, our case of eosinophilic polymyositis is unique as it presented with severe rhabdomyolysis without another organ involvement. Clinicians should maintain a high index of suspicion for this physically debilitating disease to aid in prompt diagnosis.

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Parasitic infections and myositis

Cited by 31 publications

References 225 publications

Muskuläre Sarkozystose nach Malaysiareise: eine Fallserie aus Deutschland

Muskuläre Sarkozystose nach Malaysiareise: eine Fallserie aus Deutschland

Therapeutic Administration of IL-10 and Amphiregulin Alleviates Chronic Skeletal Muscle Inflammation and Damage Induced by Infection

Severe Rhabdomyolysis without Systemic Involvement: A Rare Case of Idiopathic Eosinophilic Polymyositis

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