title: Toxoplasmic myositis as a presenting manifestation of idiopathic CD4 lymphocytopenia.
abstract: Toxoplasma gondii encysts in skeletal muscle. Although only rarely found at muscle biopsy, this parasite has previously been regarded as a possible cause of polymyositis. We report a case of biopsy-proven toxoplasmic myositis in a non-HIV-infected patient that led to recognition of idiopathic CD4 lymphocytopenia (ICL), a rare condition typically associated with opportunistic infections. Interestingly, the CD25(+) subset that corresponds to the CD4(+) regulatory T cells controlling autoimmune processes was lacking. Steroid and antiprotozoal therapy led to recovery.
authors.affiliation: Equipe Mixte 0011 INSERM/Université Paris XII Système neuromusculaire et inflammation, CHU Henri Mondor, Créteil, France.
authors.forename: Anne
authors.initials: A
authors.lastname: Plonquet
authors.forename: Guillaume
authors.initials: G
authors.lastname: Bassez
authors.forename: François-Jérôme
authors.initials: FJ
authors.lastname: Authier
authors.forename: Jean Marc
authors.initials: JM
authors.lastname: Dray
authors.forename: Jean Pierre
authors.initials: JP
authors.lastname: Farcet
authors.forename: Romain K
authors.initials: RK
authors.lastname: Gherardi
mesh_terms: D000818:Animals; D017252:CD3 Complex / Q000378:metabolism; D018791:CD4 Lymphocyte Count; D006684:HLA-DR Antigens / Q000097:blood; D006801:Humans; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000276:immunology / Q000469:parasitology* / Q000503:physiopathology; D009220:Myositis / Q000276:immunology / Q000469:parasitology* / Q000503:physiopathology; D009894:Opportunistic Infections / Q000276:immunology / Q000469:parasitology* / Q000503:physiopathology; D018344:T-Lymphocytopenia, Idiopathic CD4-Positive / Q000150:complications* / Q000276:immunology / Q000503:physiopathology; D014122:Toxoplasma / Q000166:cytology / Q000276:immunology; D014123:Toxoplasmosis / Q000150:complications* / Q000276:immunology / Q000503:physiopathology
chemical_list: D017252:CD3 Complex; D006684:HLA-DR Antigens