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An atypical case of focal myositis

2022-05Journal article Open access
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dc.contributor.authorSilva, Ana Bento da
dc.contributor.authorTorres, Rita Pinheiro
dc.contributor.authorLourenço, Maria Helena
dc.contributor.authorCabral, Catarina
dc.contributor.authorReis, Rita
dc.contributor.authorCunha-Branco, Jaime
dc.contributor.authorGonçalves, Maria João
dc.date.accessioned2023-08-30T11:34:22Z
dc.date.available2023-08-30T11:34:22Z
dc.date.issued2022-05
dc.description.abstractA 64-year-old woman presented with a 10-day history of painful progressive bilateral temporal and right retroauricular region tumefaction, dysphonia, and a body temperature of 37.5°C. She had been previously prescribed antibiotics assuming an oral infection, with no benefit. She had no other complaints and her past medical history and clinical exam were otherwise unremarkable. Her labs revealed high levels of CRP (11.7 mg/dl), ESR (52 mm/h), creatine kinase (CK 623 U/l), myoglobin (83 U/l), aspartate transaminase (56 U/l) and alanine transaminase (69 U/l). Serologies were negative for Treponema pallidum, human immunodeficiency, hepatitis B and C, and Epstein–Barr viruses; blood cultures and immunological study, including anti-nuclear antibodies and antibodies associated with inflammatory myopathies, were negative. A facial MRI revealed thickening and T2/FLAIR hypersignal of the temporal, masseter, and pterygoid muscles with signal intensification after gadolinium injection, suggesting myositis. A temporal muscle biopsy showed marked lymphocyte infiltration (predominantly lymphocyte T CD3), as well as the marking of multiple fibres with major histocompatibility complex class I products, which supported the diagnosis. Prednisolone 0.5 mg/kg/day (30 mg) was started, with marked clinical improvement and normalization of CRP, ESR, and CK.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationSilva AB, Torres RP, Lourenço MH, Cabral C, Reis R, Gonçalves MJ, et al. An atypical case of focal myositis. Rheumatology. 2022;61(6):e158-9.pt_PT
dc.identifier.doi10.1093/rheumatology/keab574pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.21/16431
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherOxford Academicpt_PT
dc.relation.publisherversionhttps://academic.oup.com/rheumatology/article/61/6/e158/6324823pt_PT
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/pt_PT
dc.subjectMasticatory musclespt_PT
dc.subjectMyositispt_PT
dc.subjectFocal myositispt_PT
dc.titleAn atypical case of focal myositispt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPagee159pt_PT
oaire.citation.issue6pt_PT
oaire.citation.startPagee158pt_PT
oaire.citation.titleRheumatologypt_PT
oaire.citation.volume61pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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