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Granulomatous Myositis


Presentation

  • There are, however, a few reports of granulomatous muscle disease presenting with flexion contractures of the limbs.[ncbi.nlm.nih.gov]
Splenomegaly
  • 447 Splenomegaly and Hepatomegaly 448 Spontaneous Miscarriage 450 Squamous Cell Carcinoma 451 Status Epilepticus 452 Stomatitis Bullous 453 Stomatitis Red Lesions 454 Strabismus 455 Stroke 456 Stroke Young Adult Causes 458 STSegment Elevations Nonischemic[books.google.com]
Lymphadenopathy
  • She lacked clinical and physical findings of arthritis, weakness, rash, uveitis, fever, lymphadenopathy or respiratory symptoms.[ncbi.nlm.nih.gov]
  • A chest radiograph was negative for lymphadenopathy or parenchymal changes. A contrasted CT scan of the chest, abdomen and pelvis also showed no lymphadenopathy or hepatosplenomegaly.[ped-rheum.biomedcentral.com]
  • Leg Ulcers 300 LeggCalvéPerthes Disease 301 Leptomeningeal Lesions 302 Leukoplakia Oral Hairy Oral Hairy Cell Leukoplakia 303 Lichen Simplex Chronicus 304 Listeriosis 305 Liver Lesions Benign Often Confused with Malignancy 306 Lumbar Disk Syndrome 307 Lymphadenopathy[books.google.com]
Popliteal Swelling
  • Swelling 397 Postconcussive Syndrome 398 Posttraumatic Stress Disorder 399 Preeclampsia 400 Premenstrual Dysphoric Disorder 401 Pronator Syndrome 402 Proteinuria 403 Pruritus Ani 404 Pseudofolliculitis Barbae Ingrown Hairs Razor Bumps 405 Pseudoinfarction[books.google.com]
Sore Throat
  • Scrotal Pain 432 Seasonal Affective Disorder 433 Seizures Absence 434 Septicemia 435 Serotonin Syndrome 436 Sexually Transmitted Diseases Anorectal Region 437 Shoulder Pain 438 Sialadenitis 439 Silicosis 440 Small Bowel Obstruction 441 Smallpox 442 Sore[books.google.com]
Rhinitis
  • Phenomenon 416 Rectal Pain 417 Red Hot Joint 418 Renal Cell Adenocarcinoma 419 Renal Failure Postrenal Causes 420 Renal Tubular Acidosis 421 Respiratory Failure Hypoventilatory 422 Reticulocytosis 423 Retinopathy Hypertensive 424 Rheumatic Fever 425 Rhinitis[books.google.com]
Nausea
  • A 16 year old Caucasian female presented with protracted symptoms of fatigue, nausea and prominent weight loss with laboratory evidence of hypercalcemia and renal insufficiency.[ncbi.nlm.nih.gov]
  • Case presentation A 16 year old Caucasian female presented with protracted symptoms of fatigue, nausea and prominent weight loss with laboratory evidence of hypercalcemia and renal insufficiency.[ped-rheum.biomedcentral.com]
Rectal Pain
  • Pain 417 Red Hot Joint 418 Renal Cell Adenocarcinoma 419 Renal Failure Postrenal Causes 420 Renal Tubular Acidosis 421 Respiratory Failure Hypoventilatory 422 Reticulocytosis 423 Retinopathy Hypertensive 424 Rheumatic Fever 425 Rhinitis Allergic 426[books.google.com]
Lactose Intolerance
  • Intolerance 296 Laryngitis 297 Left Axis Deviation 298 Leg Length Discrepancies 299 Leg Ulcers 300 LeggCalvéPerthes Disease 301 Leptomeningeal Lesions 302 Leukoplakia Oral Hairy Oral Hairy Cell Leukoplakia 303 Lichen Simplex Chronicus 304 Listeriosis[books.google.com]
Vomiting
  • During her evaluation, the patient continued to be symptomatic from hypercalcemia with fatigue, nausea and vomiting and had progressive normocytic anemia to a nadir of hemoglobin 9.1 g/dl with elevated erythrocyte sedimentation rate (ESR) of 31 mm/h ([ped-rheum.biomedcentral.com]
Jugular Venous Distention
  • Venous Distention 291 Kawasakis Disease 292 Kidney Enlargement Unilateral 293 Knee Pain in Different Age Groups 294 Korsakoffs Psychosis 295 Lactose Intolerance 296 Laryngitis 297 Left Axis Deviation 298 Leg Length Discrepancies 299 Leg Ulcers 300 LeggCalvéPerthes[books.google.com]
Xerostomia
  • Paralysis 500 Volume Excess 501 Vulvar Cancer 502 Vulvovaginitis Bacterial 504 Vulvovaginitis Trichomonas 505 Weakness Gradual Onset 506 Weight Loss 507 Wheezing 508 Whiplash 509 Wrist Pain 510 Wrist and Hand Pain in Different Age Groups 511 Xanthoma 513 Xerostomia[books.google.com]
Xanthoma
  • Vocal Cord Paralysis 500 Volume Excess 501 Vulvar Cancer 502 Vulvovaginitis Bacterial 504 Vulvovaginitis Trichomonas 505 Weakness Gradual Onset 506 Weight Loss 507 Wheezing 508 Whiplash 509 Wrist Pain 510 Wrist and Hand Pain in Different Age Groups 511 Xanthoma[books.google.com]
Papilledema
  • Orbital Lesions Cystic 359 Orofacial Pain 360 OsgoodSchlatter Disease 361 Osteoporosis 362 Otitis Externa 363 Ovarian Mass 364 Pagets Disease of Bone 365 Pain Midfoot 366 Pain Posterior Heel 367 Palpitations 368 Pancreatitis Acute 369 Panic Disorder 370 Papilledema[books.google.com]
Rabies
  • 404 Pseudofolliculitis Barbae Ingrown Hairs Razor Bumps 405 Pseudoinfarction 406 Psittacosis 407 Ptosis 408 Puberty Delayed 409 Puberty Precocious 410 Pulmonary Hypertension Primary 411 Pulmonary Nodule Solitary 412 Purpura 413 Pyogenic Granuloma 414 Rabies[books.google.com]
Renal Insufficiency
  • A 16 year old Caucasian female presented with protracted symptoms of fatigue, nausea and prominent weight loss with laboratory evidence of hypercalcemia and renal insufficiency.[ncbi.nlm.nih.gov]
  • Case presentation A 16 year old Caucasian female presented with protracted symptoms of fatigue, nausea and prominent weight loss with laboratory evidence of hypercalcemia and renal insufficiency.[ped-rheum.biomedcentral.com]
Incontinence
  • Immune Thrombocytopenic Purpura 277 Impotence 278 Incontinence Fecal 279 Infertility Male 280 Influenza 281 Interstitial Cystitis 282 Intracranial Lesion 283 Irritable Bowel Syndrome 284 Ischemic Colitis Nonocclusive 285 Jaundice 286 Jaundice in the Adult[books.google.com]
Urethral Discharge
  • Discharge and Dysuria 486 Urinary Retention Acute 487 Urine Red 488 Urolithiasis 489 Urticaria Hives 490 Uterine Myoma 491 Vaginal Bleeding Pregnancy 492 Varicocele 493 Vasculitis Diseases That Mimic Vasculitis 494 Venous Lake 495 Ventricular Septal[books.google.com]
Testicular Pain
  • Pain 468 Tetanus 469 Thromboangiitis Obliterans 470 Thrombocytopenia Inherited Disorders 471 Thrombocytopenia in Pregnancy 472 Thrombophlebitis Superficial 473 Thyroid Nodule 474 TickRelated Infections 475 Tinea Corporis 476 Tinea Versicolor Pityriasis[books.google.com]

Workup

  • In extensive diagnostic workup underlying primary granulomas forming diseases were excluded and corticoid therapy was initiated, but without clinical effect.[ncbi.nlm.nih.gov]
  • Conclusions Sarcoidosis should be considered in patients presenting with symptomatic hypercalcemia with no apparent causes and negative routine workup.[ped-rheum.biomedcentral.com]
Left Axis Deviation
  • Axis Deviation 298 Leg Length Discrepancies 299 Leg Ulcers 300 LeggCalvéPerthes Disease 301 Leptomeningeal Lesions 302 Leukoplakia Oral Hairy Oral Hairy Cell Leukoplakia 303 Lichen Simplex Chronicus 304 Listeriosis 305 Liver Lesions Benign Often Confused[books.google.com]
Microcytosis
  • Macrothrombocytopenia Inherited 312 Malaria 313 MalloryWeiss Tear 314 Mastoiditis 315 Mediastinitis Acute 316 Melanocytic Nevi Moles 317 Melanonychia 318 Menieres Disease 319 Meningitis Chronic 320 Menopause 321 Metabolic Syndrome 322 Metatarsalgia 323 Microcytosis[books.google.com]
Multiple Ulcerations
  • Proctoscopy was normal to a level of 20 cm from the anal margin, at which point multiple ulcerations, 2 to 3 mm, extended to the length of the proctoscope. Biopsies showed . . .[nejm.org]

Treatment

  • The clinical presentation, MR imaging appearances, pathologic features and excellent response to treatment with immunosuppression are described.[ncbi.nlm.nih.gov]
  • Steroids are the first line of treatment. It is unfortunate that you did not improve with this. In your case, other immune suppression treatments would be alternative treatment options. These include: 1. Methotrexate, 2. Azathioprine, 3.[healthmagic.gq]
  • There are a number of over the counter treatment options available to help you get rid of Inclusion Body Myositis but only a doctor can help you recommend a suitable treatment or an appropriate medication which can help you get rid of this disorder.[inclusionbody.wordpress.com]

Prognosis

  • Prognosis [ 15 ] The prognosis of the idiopathic inflammatory myopathies is very variable. An associated malignancy indicates a poor prognosis for recovery and increases mortality.[patient.info]
  • Involvement of respiratory muscles in these patients is associated with a poor prognosis. Esophagus.[ahcmedia.com]
  • Long-term prognosis of patients with juvenile dermatomyositis initially treated with intravenous methylprednisolone pulse therapy. Clin Exp Rheumatol. 1999 Sep-Oct. 17(5):621-4. [Medline].[emedicine.medscape.com]
  • Patients with myositis are diagnosed at an earlier age and have a worse prognosis. Myositis, muscle atrophy, microtubular inclusion, and mononuclear cell infiltrates are found at histology [ 2 ].[ajronline.org]

Etiology

  • This type of lesion is compatible with a parasitic etiology. In fact, some muscle fibers were spotted with Sarcocystis spp. cysts within their cytoplasm, but those were not associated with the lesions.[cresa.cat]
  • Our case underscores the importance of considering sarcoidosis or granulomatous myositis in patients who present with hypercalcemia of unclear etiology and reinforces the need for tissue diagnosis and exclusion of other causes.[ped-rheum.biomedcentral.com]
  • “Inflammatory Muscle Disease: Etiology and pathogenesis, in Rheumatology”. 2003. pp. 1523-1536. Nirmalananthan, N, Holton, J.L, Hanna, M.G. “Is it really myositis? A consideration of the differential diagnosis”.[rheumatologyadvisor.com]
  • Recurrent scratching of skin is believed to play a role in the etiology of these lesions.[ahcmedia.com]
  • Granulomatous myositis General Etiology: [34] Sarcoidosis Idiopathic Infectious ( Tuberculosis, Syphillis, Brucellosis Foreign-body reaction Thymoma - myasthenia gravis Lymphoma - paraneoplastic Primary biliary cirrhosis Sarcoidosis ( H&E ) Granulomatous[librepathology.org]

Epidemiology

  • Endomysium - histological slide Epidemiology The condition affects people with African or Caribbean ancestry at almost double the rate that it affects Caucasians.[kenhub.com]
  • Epidemiology Polymyositis tends to present between 30 and 60 years of age with a smaller peak at about 15 years of age. Dermatomyositis can occur in people of any age.[patient.info]
  • Epidemiology The idiopathic inflammatory myopathies are rare disorders. The overall annual incidence is approximately 1 in 100,000.[ahcmedia.com]
Sex distribution
Age distribution

Pathophysiology

  • Moreover, further evidence is warranted that titin and, particularly, ryanodine receptor antibodies may co-occur or be pathophysiologically involved in myasthenia-myositis cases.[ncbi.nlm.nih.gov]
  • Pathophysiology On muscle biopsy, the muscle cells show small rimmed vacuoles, and no evidence of inflammation. This separates it from the inflammatory myopathies such as polymyositis and dermatomyositis.[kenhub.com]
  • These organized collections of immune cells have important pathophysiologic action including cytokine production leading to inflammation as well as enzymatic conversion of cholecalciferol to calcitriol via 1-α hydroxylase.[ped-rheum.biomedcentral.com]
  • It appears increasingly that myositis-specific autoantibodies play a specific role in the pathophysiology of the idiopathic inflammatory myopathies.[ahcmedia.com]

Prevention

  • Rapidly find the answers you need with separate sections on diseases and disorders, differential diagnosis, clinical algorithms, laboratory results, and clinical preventive services, plus an at-a-glance format that uses cross-references, outlines, bullets[books.google.com]
  • As we all know this disorder is caused by serious autoimmune disturbances therefore it cannot be prevented without any special treatment that hits the right target and act against the symptoms of this disease.[inclusionbody.wordpress.com]
  • These include physical therapy and rehabilitation, prophylactic measures to prevent aspiration, avoiding decubitus ulcers and DVTs in bedridden patients, and educating patients with dermatomyositis to avoid UV light and sun exposure. 24 Successful management[ahcmedia.com]

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