July 2003: 62-year-old female with progressive muscular weakness.
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.
Bornemann
Antje
A
Institute of Brain Research, Eberhard-Karls University, Tübingen, Germany.
Bohl
Jürgen
J
Schneider
Hans-Michael
HM
Goebel
Hans H
HH
Schmidt
Peter F
PF
Gherardi
Romain K
RK
D000536:Aluminum Hydroxide / Q000009:adverse effects*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D002479:Inclusion Bodies / Q000737:chemistry / Q000648:ultrastructure; D008264:Macrophages / Q000473:pathology* / Q000648:ultrastructure; D013058:Mass Spectrometry; D008854:Microscopy, Electron; D008875:Middle Aged; D018908:Muscle Weakness / Q000209:etiology* / Q000473:pathology* / Q000503:physiopathology; D018482:Muscle, Skeletal / Q000473:pathology* / Q000648:ultrastructure; D020391:Muscular Dystrophy, Facioscapulohumeral / Q000473:pathology; D014761:Viral Hepatitis Vaccines / Q000009:adverse effects*
D014761:Viral Hepatitis Vaccines; D000536:Aluminum Hydroxide