Localised gastrocnemius myositis in Crohn's disease.
A19-year-old woman presented with pain and tenderness in both calves associated with pyrexia and neutrophil leukocytosis. Gastrocnemius muscle biopsy showed a non-specific lymphocytic myositis and she was found to have positive c-ANCA, in the absence of other evidence of systemic vasculitis. Subsequent investigation of her gastrointestinal tract revealed extensive Crohn's disease. The myositis responded promptly to treatment with prednisolone 0.5 mg/kg. A review of the literature showed that localised calf pain in the setting of Crohn's disease can be caused by non-specific myositis, granulomatous myositis or vasculitis. It is proposed that the "gastrocnemius myalgia syndrome" be included in the typical - albeit rare - extraintestinal manifestations that may herald the appearance of inflammatory bowel disease.
"Amalia Fleming" General Hospital, 7 Vas Alexandrou Street, Kifissia, Athens 14561, Greece. chrada@ath.forthnet.gr
C
C
Christopoulos
S
S
Savva
S
S
Pylarinou
A
A
Diakakis
E
E
Papavassiliou
P
P
Economopoulos
D000328:Adult; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D019268:Antibodies, Antineutrophil Cytoplasmic / Q000276:immunology; D003424:Crohn Disease / Q000150:complications* / Q000175:diagnosis / Q000276:immunology; D005260:Female; D006801:Humans; D018482:Muscle, Skeletal / Q000473:pathology*; D009220:Myositis / Q000188:drug therapy* / Q000209:etiology* / Q000276:immunology; D011239:Prednisolone / Q000627:therapeutic use*
D000893:Anti-Inflammatory Agents; D019268:Antibodies, Antineutrophil Cytoplasmic; D011239:Prednisolone