[Relationships between rhizomelic pseudo-polyarthritis and mitochondrial myopathy. 24 cases].
OBJECTIVE
Diagnosis of polymyalgia rheumatica requires the elimination of other inflammatory diseases due to the lack of a specific diagnostic criteria. Since results of muscle biopsy have been considered non-specific, we evaluated the full spectrum of histological, histochemical and biochemical data observed in 24 patients with suspected polymyalgia rheumatica.


METHODS
From January 1989, the diagnosis of polymyalgia rheumatica was suspected in 24 patients (4 males, 20 females; mean age 67.8 years, range 50-88) hospitalized in our unit for inflammatory joint and muscle pain with a current duration of 6-30 months. Muscle biopsies were obtained in each case.


RESULTS
Based on the histological, histo-enzymatic, ultrastructural and biochemical analyses, 19 patients fulfilled the criteria defining mitochondrial myopathies. After favourable outcome (reduced pain, involution of biochemical inflammatory syndrome) following prednisone therapy (0.5 mg/kg/day) a second muscle biopsy revealed identical abnormalities.


CONCLUSIONS
These muscular diseases have been described mainly as hereditary encephalo-myopathies, but in our series the mitochondrial myopathy may have preceded the polymyalgia rheumatica or been acquired, aggravating the inflammatory process. Muscle biopsy might act as a referee for diagnosis.
Harlé
J R
JR
Service de Médecine interne, Hôpital de la Timone, Marseille.
Disdier
P
P
Bolla
G
G
Coulom
F
F
Figarella-Branger
D
D
Desnuelle
C
C
Pellissier
J F
JF
Weiller
P J
PJ
D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D030401:Cytochrome-c Oxidase Deficiency; D003937:Diagnosis, Differential; D014450:Electron Transport Complex III / Q000172:deficiency; D005260:Female; D006801:Humans; D008297:Male; D008854:Microscopy, Electron; D008875:Middle Aged; D017240:Mitochondrial Myopathies / Q000150:complications / Q000473:pathology*; D016660:NAD(P)H Dehydrogenase (Quinone) / Q000172:deficiency; D011111:Polymyalgia Rheumatica / Q000150:complications / Q000188:drug therapy / Q000201:enzymology / Q000473:pathology*; D011241:Prednisone / Q000627:therapeutic use
D016660:NAD(P)H Dehydrogenase (Quinone); D014450:Electron Transport Complex III; D011241:Prednisone
Relations entre pseudopolyarthrite rhizomélique et myopathie mitochondriale. 24 observations.