Toxoplasmic myositis as a presenting manifestation of idiopathic CD4 lymphocytopenia.
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.
Plonquet
Anne
A
Equipe Mixte 0011 INSERM/Université Paris XII Système neuromusculaire et inflammation, CHU Henri Mondor, Créteil, France.
Bassez
Guillaume
G
Authier
François-Jérôme
FJ
Dray
Jean Marc
JM
Farcet
Jean Pierre
JP
Gherardi
Romain K
RK
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
D017252:CD3 Complex; D006684:HLA-DR Antigens