[Macrophagic myofasciitis: inflammatory, vaccination-associated muscular disease].

摘要: HISTORY AND ADMISSION FINDINGS A 67-year-old man presented with a 6-week history of slowly progressive muscle pain and generalized muscular weakness. Neurological examination showed symmetrical proximal weakness (MRC grade 4/5). INVESTIGATIONS Laboratory tests revealed an elevated CK level 124 U/l (normal < 80). Needle EMG pathological spontaneous activity in groups. diagnostic biopsy taken from the left deltoid characteristic infiltrate PAS-positive acid phosphatase-positive macrophages. Electron microscopic analysis tissue failed to demonstrate aluminium hydroxide inclusion. Serological excluded antibodies against HAV HBV but was compatible previous tetanus vaccination (antibody titre 2.3 IE/ml). TREATMENT 2-year treatment steroids azathioprine led complete recovery strength without relapse after discontinuing immunosuppression. CONCLUSION Macrophagic myofasciitis (MMF) is rare inflammatory disorder characterized by infiltration macrophages, which caused persistence vaccine-derived hydroxide. The diagnosis can only be established open that used for intramuscular vaccination.