Toxic Myopathies

Pasnoor, Mamatha; Barohn, Richard J.; Dimachkie, Mazen M.

doi:10.1016/j.ncl.2014.04.009

Cited by 49 publications

(76 citation statements)

References 119 publications

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“…We recruited 202 HIV-infected children (median age 11 years [IQR [8][9][10][11][12][13]; 48.8% female) and 285 uninfected children (median age 10 years [IQR [8][9][10][11][12][13]; 48.8% female). There was no significant difference in age or sex…”

Section: Baseline Characteristics Of Participantsmentioning

confidence: 99%

Disability, social functioning and school inclusion among older children and adolescents living with HIV in Zimbabwe

Rukuni

McHugh

Majonga

et al. 2017

Tropical Med Int Health

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ObjectiveIncreasing numbers of children with HIV are surviving to adolescence and encountering multiple clinical and social consequences of long‐standing HIV infection. We aimed to investigate the association between HIV and disability, social functioning and school inclusion among 6‐ to 16‐year‐olds in Zimbabwe.MethodsHIV‐infected children receiving antiretroviral therapy from a public‐sector HIV clinic and HIV‐uninfected children attending primary care clinics in the same catchment area were recruited. Standardised questionnaires were used to collect socio‐demographic, social functioning and disability data. Multivariable logistic regression was used to assess the relationship between HIV status and disability and functioning.ResultsWe recruited 202 HIV‐infected and 285 HIV‐uninfected children. There was no difference in age and gender between the two groups, but a higher proportion of HIV‐infected children were orphaned. The prevalence of any disability was higher in HIV‐infected than uninfected children (37.6% vs. 18.5%, P < 0.001). HIV‐infected children were more likely to report anxiety (adjusted odds ratio (aOR) 4.4; 95% CI 2.4, 8.1), low mood (aOR 4.2; 2.1, 8.4) and difficulty forming friendships (aOR 14.8; 1.9, 116.6) than uninfected children. Children with HIV also reported more missed school days, repeating a school year and social exclusion in class. These associations remained apparent when comparing children with HIV and disability to those with HIV but no disabilities.ConclusionsChildren with HIV commonly experience disabilities, and this is associated with social and educational exclusion. Rehabilitation and support services are needed to facilitate educational attainment and social participation in this group.

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Section: Baseline Characteristics Of Participantsmentioning

confidence: 99%

Disability, social functioning and school inclusion among older children and adolescents living with HIV in Zimbabwe

Rukuni

McHugh

Majonga

et al. 2017

Tropical Med Int Health

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“…The muscle adverse events in patients with toxic SaMAEs stabilise and show marked improvement within 2-3 months following statin cessation. 18 Until recently, SaMAEs referred to the nonautoimmune form. 26 Autoimmune inflammatory myositis and/or necrotising myopathy, on the other hand, starts or persists even after drug discontinuation.…”

Section: Classificationmentioning

confidence: 99%

“…31 This pathology may occur without CK elevations as the muscle fibre damage is largely restricted to the intracellular space while the 32 In cases of toxic necrotising myopathy, muscle fibre necrosis with prominent phagocytosis and small basophilic regenerating fibres have been observed in patients with elevated serum CK levels and weakness or myalgia; these patients did not have detectable HMGCR antibodies. 18 In anti-HMGCR clinical syndrome, autoimmune inflammatory myositis and/or necrotising myopathy is observed. 17 Necrotising myopathy is a characteristic pathological pattern consisting of scattered muscle fibre necrosis and regeneration, macrophage infiltrates, a few endomysial inflammatory cells (including cluster of differentiation [CD] 4+ and CD8+ T cells and plasmacytoid dendritic cells) and sarcolemmal complement deposition on the surface of non-necrotic muscle fibres.…”

Section: Muscle Biopsy Findingsmentioning

confidence: 99%

Statin-Associated Muscle Adverse Events: Update for clinicians

Al-Mohaissen¹,

Ignaszewski²,

Fröhlich³

et al. 2016

SQUMJ

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Statins are potent medications which reduce low-density lipoprotein cholesterol (LDL-C) levels. Their efficacy in cardiovascular risk reduction is well established and indications for their use are expanding. While statins are generally well tolerated and safe, adverse events are relatively common, particularly statinassociated muscle adverse events (SaMAEs), which are the most frequently encountered type of adverse event. Recent guidelines and guideline updates on SaMAEs and statin intolerance have included revised definitions of SaMAEs, incorporating new evidence on their pathogenesis and management. As SaMAEs emerge as a therapeutic challenge, it is important for physicians to be aware of updates on management strategies to ensure better patient outcomes. The majority of patients who are considered statin-intolerant can nevertheless tolerate some forms of statin therapy and successfully achieve optimal LDL-C levels. This review article discusses the recent classification of SaMAEs with emphasis on pathogenesis and management strategies.

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“…These myopathies can be related to autoimmune mechanisms by the presence of specific autoantibodies such as anti-SRP and anti-HMGCR, or may be associated with specific connective tissue disorders [4]. Others are secondary to toxic agents [5], viral infections or reveal a paraneoplastic manifestation [2].…”

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confidence: 99%