Vacuolar Myopathy in Systemic Lupus Erythematosus

Pearson, Carl M.; Yamazaki, James N.

doi:10.1093/ajcp/29.5.455

Cited by 39 publications

(9 citation statements)

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“…This has shown a proximal distribution, the lower limbs usually being more severely affected. Histologically, the muscles display a vacuolar change, similar to that reported in systemic lupus erythematosus by Pearson & Yamazaki (1958). The vacuolar changes are associated with the accumulation of glycogen and it has therefore been suggested that chloroquine damages muscle by affecting enzymes involved in glycogen metabolism (Eadie & Ferrier, 1966).…”

Section: Chloroquine Myopathysupporting

confidence: 61%

Metabolic myopathy

Thomas

1967

Postgraduate Medical Journal

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Section: Chloroquine Myopathysupporting

confidence: 61%

Metabolic myopathy

Thomas

1967

Postgraduate Medical Journal

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“…Colchicine, alcohol, glucocorticoids, and cyclosporine toxicities can lead to similar light microscopy findings. Other possible, albeit less common, differential diagnoses of myopathy with autophagic vacuoles on light microscopy are fairly broad and include metabolic disorders such as acid maltase deficiency among other conditions . Type IIB fiber atrophy was seen in patient B on muscle biopsy which might be related to their steroid use, making steroid myopathy another possible differential.…”

Section: Discussionmentioning

confidence: 99%

Hydroxychloroquine‐induced autophagic vacuolar myopathy with mitochondrial abnormalities

Khosa

Khanlou²,

Khosa

et al. 2018

Neuropathology

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Hydroxychloroquine (HCQ) and chloroquine are used worldwide for malaria as well as connective and rheumatological disorders. They have been reported to be linked to myopathy in patients. We report four patients who were receiving HCQ as part of treatment for connective tissue disorder and who presented with myopathy. The muscle biopsy in these patients was consistent with findings of HCQ toxicity. HCQ muscle toxicity is usually self‐limiting after discontinuation of the drug. It also usually tends to be under‐reported due to presence of various confounding factors. This warrants close monitoring and consideration of muscle biopsy as part of initial work up of patients who present with myopathy while receiving HCQ.

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“…Other studies have focused chiefly on specific abnormalities in muscle specimens from patients with SLE." [11][12][13][14][15][16] The absence of lymphocytic vasculitis and/or myositis in the control group suggests that such changes signify pathology related to the presence of SLE. The relationship between lymphocytic vasculitis and clinical and laboratory parameters has not been examined previously.…”

Section: Discussionmentioning

confidence: 99%

Muscle biopsy abnormalities in systemic lupus erythematosus: correlation with clinical and laboratory parameters.

Lim

Abdulwahab

Lowe

et al. 1994

Annals of the Rheumatic Diseases

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Objectives-To investigate the incidence and significance of Type II fibre atrophy, vessel wall thickening, lymphocytic vasculitis and myositis in needle quadriceps muscle biopsies from patients with systemic lupus erythematosus (SLE) and their correlations with clinical and laboratory parameters. Methods-Needle quadriceps muscle biopsies from 55 patients with SLE and 26 controls were prospectively examined. Clinical and laboratory parameters recorded at the time of muscle biopsy included arthralgia, arthritis, myalgia, proximal weakness, vasculitic rashes, Schirmer test, ENA antibodies, ESR, serum creatine kinase (CK) and plasma C3 degradation products. Results-Abnormal muscle biopsies were significantly more frequent in patients with SLE compared with controls (P<0.005).None of the controls had lymphocytic vasculitis and/or myositis. The difference in incidence between patients with SLE and controls for lymphocytic vasculitis was significant at P<0 005. Due to the small number of SLE patients with myositis, the difference in incidence for this abnormal finding reached only P = 0 09. In the SLE patient group, lymphocytic vasculitis was associated with significantly higher ESR values (P = 0.007) and higher incidence of arthritis (P = 0.01); and appears to characterise a subset of patients with positive Schirmer tests, anti-Ro and/or anti-La antibodies. Raised seruip CK was found to correspond with underlying myositis in patients with SLE and these patients also had an increased incidence of symptoms of proximal weakness and/or anti-RNP antibodies. In contrast, both Type II fibre atrophy and vessel wall thickening failed to correlate with any of the clinical and laboratory parameters studied and appear to be non-specific findipgs.Cone#usions-Abnormal muscle biopsies are common in patients with SLE and the presence of lymphocytic vasculitis and/or myositis signify pathology in these patients. Histopathological abnormalities in needle quadriceps muscle biopsies are further valuable parameters in the assessment of patients with SLE.

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Vacuolar Myopathy in Systemic Lupus Erythematosus

Cited by 39 publications

References 0 publications

Metabolic myopathy

Metabolic myopathy

Hydroxychloroquine‐induced autophagic vacuolar myopathy with mitochondrial abnormalities

Muscle biopsy abnormalities in systemic lupus erythematosus: correlation with clinical and laboratory parameters.

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