1. July 2003: 62-year-old female with progressive muscular weakness
- Author
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Ronald L. Hamilton, Antje Bornemann, J¨rgen Bohl, Hans-Michael Schneider, Hans H. Goebel, Peter F. Schmidt, and Roamain K. Gherardi
- Subjects
Viral Hepatitis Vaccines ,medicine.medical_specialty ,Aluminum Hydroxide ,Mass Spectrometry ,Cases of the Month: July to September 2003 ,Pathology and Forensic Medicine ,Diagnosis, Differential ,Biopsy ,medicine ,Humans ,Muscle, Skeletal ,Myopathy ,Inclusion Bodies ,Hepatitis ,Muscle Weakness ,Pelvic girdle ,medicine.diagnostic_test ,business.industry ,Macrophages ,General Neuroscience ,Macrophagic myofasciitis ,Middle Aged ,medicine.disease ,Muscular Dystrophy, Facioscapulohumeral ,Surgery ,Vaccination ,Microscopy, Electron ,Facial muscles ,medicine.anatomical_structure ,Female ,Neurology (clinical) ,medicine.symptom ,business ,Progressive muscular weakness - Abstract
The July 2003 Case of the Month (COM). A 62-year-old female patient experienced progressive muscular weakness over the last ten years, involving shoulder and pelvic girdle muscles, paraspinal and facial muscles. A biopsy was taken from the left deltoid muscle where hepatitis vaccination had taken place 4 weeks previously. The specimen revealed macrophagic myofasciitis due to the injection of aluminium-bound vaccines. The finding can be reproduced experimentally by injecting vaccines in rats. The pathomechanism is supposed to involve immune stimulation due to long term persistence of the adjuvant. Macrophagic myofasciitis has been suggested to occasionally cause myopathy but is supposed to be unrelated to the underlying myopathy in our patient.
- Published
- 2004
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